Factors That Can Facilitate and Inhibit Process of Change

Laws or regulations that enable changeLaws or regulations that restrict advancement of a role or change in responsibilities
Guidelines for practice that enable changeFear of litigation
Presence of key players who support the desired changePresence of trainee doctors who want roles that allow them to develop
Shortage of nuclear medicine physiciansFear of change
Technologic advancementFear of losing money in cases of fee for service
Financial pressure in the health care sectorFear of losing turf
Effective use of the potential skills and capabilities of all professionalsFear of losing power and status
Role models who already do advanced practicesConflict about roles
Inability to support suitable advanced practice education and training
Fear of accepting new responsibilities