From 938f351ede52a754c0fa0e14ca918edd855c7873 Mon Sep 17 00:00:00 2001
From: isaacclad <sense.corporate@gmail.com>
Date: Mon, 20 Jul 2026 09:21:26 +0000
Subject: [PATCH] Expand specialty RBAC with dedicated specialist roles and
 support access.

Add cardiologist/ENT/derm/ophthalmology/ortho/podiatry/fertility roles and
manage/refer/view matrices so GPs, nurses, lab, pharmacy, and reception get
realistic module access beyond single-app specialists.

Co-authored-by: Cursor <cursoragent@cursor.com>
---
 app/Services/Care/CarePermissions.php        | 197 +++++++++++++++--
 app/Services/Care/SpecialtyModuleService.php |  33 +--
 config/care.php                              |   7 +
 config/care_specialty_modules.php            | 214 ++++++++++++++-----
 tests/Feature/CareNurseOrgAccessTest.php     |  19 +-
 tests/Feature/CareSpecialtyAccessTest.php    |  70 ++++--
 tests/Feature/CareSpecialtyClinicalTest.php  |   2 +-
 tests/Feature/CareSpecialtyModulesTest.php   |  15 +-
 tests/Feature/CareSpecialtyShellTest.php     |  10 +-
 9 files changed, 451 insertions(+), 116 deletions(-)

diff --git a/app/Services/Care/CarePermissions.php b/app/Services/Care/CarePermissions.php
index 1c357a3..4c59660 100644
--- a/app/Services/Care/CarePermissions.php
+++ b/app/Services/Care/CarePermissions.php
@@ -5,11 +5,13 @@ namespace App\Services\Care;
 use App\Models\Member;
 
 /**
- * Care RBAC: role → abilities + primary specialty apps.
+ * Care RBAC: role → abilities + specialty manage / refer / view apps.
  *
- * Authorization must use can() / primaryAppsFor() — never role string checks
- * like isDoctor. Legacy `doctor` aliases to general_physician; `nurse` is a
- * limited floor role (ED / theatre / dialysis nurses are separate).
+ * Authorization must use can() / primaryAppsFor() / referAppsFor() /
+ * viewAppsFor() — never role string checks like isDoctor. Legacy `doctor`
+ * aliases to general_physician for abilities; desk specialists are narrowed
+ * by SpecialtyModuleService keyword matching. `nurse` is a limited floor role
+ * (ED / theatre / dialysis nurses are separate).
  *
  * Inheritance: lab_manager ⊃ lab_technician; blood_bank_manager ⊃ blood_bank_officer.
  */
@@ -28,7 +30,7 @@ class CarePermissions
     /**
      * Specialty module keys each role may open (manage). Null = no specialty
      * matrix entry (fall back to module config allowlists + desk keywords).
-     * Empty list = no specialty modules.
+     * Empty list = no specialty manage.
      *
      * @var array<string, list<string>|null>
      */
@@ -37,14 +39,20 @@ class CarePermissions
         'hospital_admin' => null,
         'emergency_physician' => ['emergency', 'radiology', 'pathology', 'blood_bank', 'cardiology'],
         'ed_nurse' => ['emergency', 'blood_bank', 'radiology', 'pathology'],
-        'general_physician' => ['emergency', 'cardiology', 'pediatrics', 'ent', 'dermatology'],
-        'doctor' => ['emergency', 'cardiology', 'pediatrics', 'ent', 'dermatology'], // legacy → GP
+        'general_physician' => [
+            'emergency', 'cardiology', 'pediatrics', 'ent', 'dermatology',
+            'ophthalmology', 'vaccination', 'child_welfare',
+        ],
+        'doctor' => [
+            'emergency', 'cardiology', 'pediatrics', 'ent', 'dermatology',
+            'ophthalmology', 'vaccination', 'child_welfare',
+        ], // legacy → GP (desk specialists narrowed elsewhere)
         'surgeon' => ['surgery', 'radiology', 'pathology', 'blood_bank'],
         'theatre_nurse' => ['surgery', 'blood_bank'],
         'radiologist' => ['radiology'],
         'radiographer' => ['radiology'],
-        'lab_technician' => ['pathology'],
-        'lab_manager' => ['pathology'],
+        'lab_technician' => ['pathology', 'blood_bank'],
+        'lab_manager' => ['pathology', 'blood_bank'],
         'pathologist' => ['pathology'],
         'blood_bank_officer' => ['blood_bank'],
         'blood_bank_manager' => ['blood_bank'],
@@ -55,14 +63,59 @@ class CarePermissions
         'midwife' => ['maternity'],
         'pediatrician' => ['pediatrics'],
         'oncologist' => ['oncology', 'infusion'],
+        'cardiologist' => ['cardiology'],
+        'ent_specialist' => ['ent'],
+        'dermatologist' => ['dermatology'],
+        'ophthalmologist' => ['ophthalmology'],
+        'orthopedist' => ['orthopedics'],
+        'podiatrist' => ['podiatry'],
+        'fertility_specialist' => ['fertility'],
         'dialysis_nurse' => ['renal'],
         'ambulance_staff' => ['ambulance', 'emergency'],
-        'receptionist' => [], // registration / queues — refer via queue.manage
+        'receptionist' => [], // refer only — see roleReferApps
         'billing_officer' => [],
         'cashier' => [],
         'accountant' => [],
         'department_manager' => null, // department analytics — all enabled modules view
-        'nurse' => [], // legacy limited — no specialty manage
+        'nurse' => ['vaccination', 'child_welfare', 'infusion', 'maternity'],
+    ];
+
+    /**
+     * Specialty modules a role may refer into (beyond manage). Empty / missing = none
+     * beyond primary apps. Manage always implies refer.
+     *
+     * @var array<string, list<string>>
+     */
+    protected array $roleReferApps = [
+        'general_physician' => [
+            'dentistry', 'physiotherapy', 'maternity', 'psychiatry', 'orthopedics',
+            'oncology', 'renal', 'surgery', 'radiology', 'pathology', 'blood_bank',
+            'infusion', 'podiatry', 'fertility', 'ambulance',
+        ],
+        'doctor' => [
+            'dentistry', 'physiotherapy', 'maternity', 'psychiatry', 'orthopedics',
+            'oncology', 'renal', 'surgery', 'radiology', 'pathology', 'blood_bank',
+            'infusion', 'podiatry', 'fertility', 'ambulance',
+        ],
+        'nurse' => ['emergency', 'pediatrics', 'blood_bank'],
+        'pharmacist' => ['oncology', 'infusion', 'maternity', 'emergency'],
+        'receptionist' => [
+            'emergency', 'pediatrics', 'vaccination', 'child_welfare', 'dentistry',
+            'maternity', 'ambulance', 'ophthalmology', 'physiotherapy',
+        ],
+    ];
+
+    /**
+     * Specialty modules a role may view without refer/manage. Empty / missing = none
+     * beyond primary + refer. Manage and refer always imply view.
+     *
+     * @var array<string, list<string>>
+     */
+    protected array $roleViewApps = [
+        'lab_technician' => ['radiology'],
+        'lab_manager' => ['radiology'],
+        'pathologist' => ['blood_bank'],
+        'pharmacist' => ['oncology', 'infusion', 'maternity', 'emergency'],
     ];
 
     /**
@@ -106,6 +159,7 @@ class CarePermissions
             'pathways.manage',
             'emergency.queue.view', 'emergency.discharge',
             'cardiology.view', 'pediatrics.view', 'ent.view', 'dermatology.view',
+            'ophthalmology.view',
             'queue.patient_board',
             'service_queues.console',
         ],
@@ -121,6 +175,7 @@ class CarePermissions
             'pathways.manage',
             'emergency.queue.view', 'emergency.discharge',
             'cardiology.view', 'pediatrics.view', 'ent.view', 'dermatology.view',
+            'ophthalmology.view',
             'queue.patient_board',
             'service_queues.console',
         ],
@@ -162,6 +217,7 @@ class CarePermissions
             'dashboard.view', 'patients.view',
             'lab.view', 'lab.manage',
             'pathology.view', 'pathology.result.enter',
+            'blood_bank.view', 'blood_bank.issue',
             // cannot: pathology.result.approve, lab.catalog.manage
             'service_queues.console',
         ],
@@ -170,6 +226,7 @@ class CarePermissions
             'pathology.result.approve',
             'analytics.lab.view',
             'lab.admin',
+            'blood_bank.manage',
         ],
         'pathologist' => [
             'dashboard.view', 'patients.view', 'appointments.view',
@@ -252,6 +309,75 @@ class CarePermissions
             'infusion.view', 'infusion.manage',
             'service_queues.console',
         ],
+        'cardiologist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'investigations.request', 'prescriptions.manage',
+            'lab.view', 'lab.results.view',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture', 'assessments.manage',
+            'pathways.manage',
+            'cardiology.view', 'cardiology.manage',
+            'service_queues.console',
+        ],
+        'ent_specialist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'investigations.request', 'prescriptions.manage',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture', 'assessments.manage',
+            'pathways.manage',
+            'ent.view', 'ent.manage',
+            'service_queues.console',
+        ],
+        'dermatologist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'investigations.request', 'prescriptions.manage',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture', 'assessments.manage',
+            'pathways.manage',
+            'dermatology.view', 'dermatology.manage',
+            'service_queues.console',
+        ],
+        'ophthalmologist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'investigations.request', 'prescriptions.manage',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture', 'assessments.manage',
+            'pathways.manage',
+            'ophthalmology.view', 'ophthalmology.manage',
+            'service_queues.console',
+        ],
+        'orthopedist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'investigations.request', 'prescriptions.manage',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture', 'assessments.manage',
+            'pathways.manage',
+            'orthopedics.view', 'orthopedics.manage',
+            'service_queues.console',
+        ],
+        'podiatrist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture',
+            'podiatry.view', 'podiatry.manage',
+            'service_queues.console',
+        ],
+        'fertility_specialist' => [
+            'dashboard.view', 'patients.view', 'appointments.view',
+            'consultations.view', 'consultations.manage',
+            'investigations.request', 'prescriptions.manage',
+            'vitals.manage',
+            'assessments.view', 'assessments.capture', 'assessments.manage',
+            'pathways.manage',
+            'fertility.view', 'fertility.manage',
+            'service_queues.console',
+        ],
         'dialysis_nurse' => [
             'dashboard.view', 'patients.view', 'appointments.view',
             'consultations.view',
@@ -301,7 +427,7 @@ class CarePermissions
             'reports.finance.view',
             'service_queues.console',
         ],
-        // Legacy nurse — floor vitals / assessments only; no specialty modules.
+        // Legacy floor nurse — vaccination / CWC / infusion / maternity manage.
         'nurse' => [
             'dashboard.view', 'patients.view', 'appointments.view',
             'consultations.view', 'vitals.manage',
@@ -317,8 +443,10 @@ class CarePermissions
         'lab_technician', 'lab_manager', 'pathologist',
         'blood_bank_officer', 'blood_bank_manager',
         'pharmacist', 'dentist', 'psychiatrist', 'physiotherapist',
-        'midwife', 'pediatrician', 'oncologist', 'dialysis_nurse',
-        'ambulance_staff', 'receptionist', 'cashier', 'billing_officer',
+        'midwife', 'pediatrician', 'oncologist',
+        'cardiologist', 'ent_specialist', 'dermatologist', 'ophthalmologist',
+        'orthopedist', 'podiatrist', 'fertility_specialist',
+        'dialysis_nurse', 'ambulance_staff', 'receptionist', 'cashier', 'billing_officer',
         'nurse',
     ];
 
@@ -327,6 +455,8 @@ class CarePermissions
         'emergency_physician', 'general_physician', 'doctor', 'surgeon',
         'radiologist', 'pathologist', 'dentist', 'psychiatrist',
         'physiotherapist', 'midwife', 'pediatrician', 'oncologist',
+        'cardiologist', 'ent_specialist', 'dermatologist', 'ophthalmologist',
+        'orthopedist', 'podiatrist', 'fertility_specialist',
         'ed_nurse', 'theatre_nurse', 'dialysis_nurse', 'ambulance_staff',
         'radiographer', 'lab_technician', 'lab_manager',
         'blood_bank_officer', 'blood_bank_manager', 'pharmacist', 'nurse',
@@ -381,7 +511,7 @@ class CarePermissions
     }
 
     /**
-     * Primary specialty module keys for this member's role.
+     * Primary specialty module keys for this member's role (manage).
      *
      * @return list<string>|null  null = unrestricted specialty (admins / dept manager use other rules)
      */
@@ -403,6 +533,41 @@ class CarePermissions
         return $this->rolePrimaryApps[$role];
     }
 
+    /**
+     * Specialty modules this role may refer into (beyond manage).
+     *
+     * @return list<string>
+     */
+    public function referAppsFor(?Member $member): array
+    {
+        if ($member === null || $this->isAdmin($member)) {
+            return [];
+        }
+
+        $role = (string) $member->role;
+        if ($role === 'department_manager') {
+            return [];
+        }
+
+        return array_values(array_unique($this->roleReferApps[$role] ?? []));
+    }
+
+    /**
+     * Specialty modules this role may view without refer/manage.
+     *
+     * @return list<string>
+     */
+    public function viewAppsFor(?Member $member): array
+    {
+        if ($member === null || $this->isAdmin($member)) {
+            return [];
+        }
+
+        $role = (string) $member->role;
+
+        return array_values(array_unique($this->roleViewApps[$role] ?? []));
+    }
+
     /**
      * Whether the role matrix lists this specialty module as a primary app.
      */
@@ -485,6 +650,8 @@ class CarePermissions
                 'emergency_physician', 'general_physician', 'doctor', 'surgeon',
                 'radiologist', 'pathologist', 'dentist', 'psychiatrist',
                 'pediatrician', 'oncologist', 'physiotherapist', 'midwife',
+                'cardiologist', 'ent_specialist', 'dermatologist', 'ophthalmologist',
+                'orthopedist', 'podiatrist', 'fertility_specialist',
             ], true);
     }
 
diff --git a/app/Services/Care/SpecialtyModuleService.php b/app/Services/Care/SpecialtyModuleService.php
index a89ca5e..24a30b5 100644
--- a/app/Services/Care/SpecialtyModuleService.php
+++ b/app/Services/Care/SpecialtyModuleService.php
@@ -358,7 +358,8 @@ class SpecialtyModuleService
      */
     public function memberCanView(Organization $organization, ?Member $member, string $key): bool
     {
-        if ($this->memberCanManage($organization, $member, $key)) {
+        if ($this->memberCanManage($organization, $member, $key)
+            || $this->memberCanRefer($organization, $member, $key)) {
             return true;
         }
 
@@ -380,14 +381,14 @@ class SpecialtyModuleService
                 return $this->specialistBelongsToModule($organization, $member, $key);
             }
 
-            // Legacy doctor (non-desk) / GP: keep refer/view on restricted modules
-            // outside primary manage via config view_roles when role is doctor/GP.
-            if (in_array((string) $member->role, ['doctor', 'general_physician'], true)
-                && ! in_array($key, $primaryApps, true)) {
-                $definition = $this->definition($key);
-                if ($definition && $this->roleListed($member, $definition['view_roles'] ?? [])) {
-                    return true;
-                }
+            if (in_array($key, $permissions->viewAppsFor($member), true)) {
+                return true;
+            }
+
+            // Secondary: config view_roles (docs + legacy allowlists).
+            $definition = $this->definition($key);
+            if ($definition && $this->roleListed($member, $definition['view_roles'] ?? [])) {
+                return true;
             }
 
             return in_array($key, $primaryApps, true);
@@ -428,12 +429,14 @@ class SpecialtyModuleService
                 return $this->specialistBelongsToModule($organization, $member, $key);
             }
 
-            if (in_array((string) $member->role, ['doctor', 'general_physician'], true)
-                && ! in_array($key, $primaryApps, true)) {
-                $definition = $this->definition($key);
-                if ($definition && $this->roleListed($member, $definition['refer_roles'] ?? [])) {
-                    return true;
-                }
+            if (in_array($key, $permissions->referAppsFor($member), true)) {
+                return true;
+            }
+
+            // Secondary: config refer_roles (docs + legacy allowlists).
+            $definition = $this->definition($key);
+            if ($definition && $this->roleListed($member, $definition['refer_roles'] ?? [])) {
+                return true;
             }
 
             return in_array($key, $primaryApps, true);
diff --git a/config/care.php b/config/care.php
index 2d8e956..a50adfd 100644
--- a/config/care.php
+++ b/config/care.php
@@ -26,6 +26,13 @@ return [
         'midwife' => 'Midwife',
         'pediatrician' => 'Pediatrician',
         'oncologist' => 'Oncologist',
+        'cardiologist' => 'Cardiologist',
+        'ent_specialist' => 'ENT Specialist',
+        'dermatologist' => 'Dermatologist',
+        'ophthalmologist' => 'Ophthalmologist',
+        'orthopedist' => 'Orthopedist',
+        'podiatrist' => 'Podiatrist',
+        'fertility_specialist' => 'Fertility Specialist',
         'dialysis_nurse' => 'Dialysis Nurse',
         'ambulance_staff' => 'Ambulance Staff',
         'nurse' => 'Nurse (legacy)',
diff --git a/config/care_specialty_modules.php b/config/care_specialty_modules.php
index 851d5af..e98633b 100644
--- a/config/care_specialty_modules.php
+++ b/config/care_specialty_modules.php
@@ -4,10 +4,10 @@
  * Specialty practice modules (Settings → Modules).
  * Pro-gated via plans.*.features specialty_modules.
  *
- * Primary specialty visibility is driven by CarePermissions::primaryAppsFor()
- * (role → module keys). Config roles / support_roles / view_roles / refer_roles
- * remain for legacy doctor desk-specialist keyword matching and GP refer/view
- * outside the primary-app matrix.
+ * Primary specialty visibility is driven by CarePermissions::primaryAppsFor() /
+ * referAppsFor() / viewAppsFor() (role → module keys). Config roles /
+ * support_roles / view_roles / refer_roles remain for legacy doctor desk-specialist
+ * keyword matching and as a secondary allowlist aligned with the matrix.
  *
  * @return array<string, array<string, mixed>>
  */
@@ -23,7 +23,17 @@ return [
         'icon' => 'bolt',
         'queue_keywords' => ['emerg', 'casualty', 'trauma', 'er', 'a&e'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'lab_technician', 'pharmacist', 'receptionist'],
+        'roles' => [
+            'emergency_physician', 'ed_nurse', 'general_physician', 'doctor',
+            'ambulance_staff',
+        ],
+        'view_roles' => [
+            'emergency_physician', 'ed_nurse', 'general_physician', 'doctor',
+            'ambulance_staff', 'nurse', 'pharmacist', 'receptionist',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'nurse', 'pharmacist', 'receptionist',
+        ],
         'default_on_paid_plans' => true,
     ],
     'blood_bank' => [
@@ -37,7 +47,18 @@ return [
         'icon' => 'droplet',
         'queue_keywords' => ['blood', 'transfusion', 'crossmatch', 'donor'],
         'access' => 'general',
-        'roles' => ['blood_bank_manager', 'lab_technician', 'nurse', 'doctor', 'receptionist'],
+        'roles' => [
+            'blood_bank_officer', 'blood_bank_manager', 'lab_technician', 'lab_manager',
+            'emergency_physician', 'ed_nurse', 'surgeon', 'theatre_nurse',
+        ],
+        'view_roles' => [
+            'blood_bank_officer', 'blood_bank_manager', 'lab_technician', 'lab_manager',
+            'pathologist', 'emergency_physician', 'ed_nurse', 'surgeon', 'theatre_nurse',
+            'general_physician', 'doctor', 'nurse',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'nurse',
+        ],
         'default_on_paid_plans' => true,
     ],
     'dentistry' => [
@@ -51,7 +72,9 @@ return [
         'icon' => 'face-smile',
         'queue_keywords' => ['dent', 'dental', 'oral'],
         'access' => 'limited',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['dentist'],
+        'view_roles' => ['dentist', 'general_physician', 'doctor', 'receptionist'],
+        'refer_roles' => ['general_physician', 'doctor', 'receptionist'],
         'specialist_keywords' => ['dent', 'dental', 'oral', 'odont'],
     ],
     'ophthalmology' => [
@@ -65,7 +88,11 @@ return [
         'icon' => 'eye',
         'queue_keywords' => ['eye', 'ophthal', 'optom'],
         'access' => 'limited',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['ophthalmologist', 'general_physician', 'doctor'],
+        'view_roles' => [
+            'ophthalmologist', 'general_physician', 'doctor', 'receptionist',
+        ],
+        'refer_roles' => ['general_physician', 'doctor', 'receptionist'],
         'specialist_keywords' => ['eye', 'ophthal', 'optom'],
     ],
     'physiotherapy' => [
@@ -79,7 +106,11 @@ return [
         'icon' => 'arrow-path',
         'queue_keywords' => ['physio', 'rehab', 'therapy'],
         'access' => 'limited',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['physiotherapist'],
+        'view_roles' => [
+            'physiotherapist', 'general_physician', 'doctor', 'receptionist',
+        ],
+        'refer_roles' => ['general_physician', 'doctor', 'receptionist'],
         'specialist_keywords' => ['physio', 'rehab', 'therapy'],
     ],
     'maternity' => [
@@ -90,10 +121,16 @@ return [
         'queue_name' => 'Maternity',
         'queue_prefix' => 'MAT',
         'nav_label' => 'Maternity',
-        'icon' => 'heart',
+        'icon' => 'home',
         'queue_keywords' => ['matern', 'antenatal', 'obstetric'],
         'access' => 'limited',
-        'roles' => ['doctor', 'nurse', 'pharmacist', 'receptionist'],
+        'roles' => ['midwife', 'nurse'],
+        'view_roles' => [
+            'midwife', 'nurse', 'general_physician', 'doctor', 'pharmacist', 'receptionist',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'pharmacist', 'receptionist',
+        ],
         'specialist_keywords' => ['matern', 'antenatal', 'obstetric', 'midwif'],
     ],
     'radiology' => [
@@ -107,7 +144,16 @@ return [
         'icon' => 'camera',
         'queue_keywords' => ['radio', 'imaging', 'x-ray', 'xray', 'ultrasound', 'ct', 'mri'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'lab_technician', 'receptionist'],
+        'roles' => [
+            'radiologist', 'radiographer', 'emergency_physician', 'ed_nurse', 'surgeon',
+        ],
+        'view_roles' => [
+            'radiologist', 'radiographer', 'emergency_physician', 'ed_nurse', 'surgeon',
+            'lab_technician', 'lab_manager', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor',
+        ],
         'specialist_keywords' => ['radio', 'radiolog', 'imaging'],
     ],
     'cardiology' => [
@@ -121,10 +167,13 @@ return [
         'icon' => 'heart',
         'queue_keywords' => ['cardio', 'heart', 'ecg', 'echo'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
-        'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse', 'lab_technician'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'roles' => ['cardiologist', 'emergency_physician', 'general_physician', 'doctor'],
+        'support_roles' => ['ed_nurse'],
+        'view_roles' => [
+            'cardiologist', 'emergency_physician', 'general_physician', 'doctor',
+            'ed_nurse',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['cardio', 'cardiology', 'heart', 'ecg'],
     ],
     'psychiatry' => [
@@ -138,10 +187,12 @@ return [
         'icon' => 'chat-bubble-left-right',
         'queue_keywords' => ['psych', 'mental', 'behaviour'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
-        'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'roles' => ['psychiatrist'],
+        'support_roles' => [],
+        'view_roles' => [
+            'psychiatrist', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['psych', 'psychiatry', 'mental', 'behaviour'],
     ],
     'pediatrics' => [
@@ -155,7 +206,13 @@ return [
         'icon' => 'user-group',
         'queue_keywords' => ['pedia', 'paedia', 'child', 'infant'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['pediatrician', 'general_physician', 'doctor'],
+        'view_roles' => [
+            'pediatrician', 'general_physician', 'doctor', 'nurse', 'receptionist',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'nurse', 'receptionist',
+        ],
         // Avoid bare "child" — collides with Child Welfare Clinic specialty labels.
         'specialist_keywords' => ['pedia', 'paedia', 'pediatric', 'paediatric', 'infant'],
     ],
@@ -170,10 +227,12 @@ return [
         'icon' => 'cube',
         'queue_keywords' => ['ortho', 'fracture', 'bone', 'joint'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
-        'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'roles' => ['orthopedist'],
+        'support_roles' => [],
+        'view_roles' => [
+            'orthopedist', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['ortho', 'orthopedic', 'orthopaedic', 'fracture'],
     ],
     'ent' => [
@@ -187,10 +246,12 @@ return [
         'icon' => 'speaker-wave',
         'queue_keywords' => ['ent', 'ear', 'nose', 'throat', 'otolaryng'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
-        'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'roles' => ['ent_specialist', 'general_physician', 'doctor'],
+        'support_roles' => [],
+        'view_roles' => [
+            'ent_specialist', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['ent', 'otolaryng', 'ear', 'nose', 'throat'],
     ],
     'oncology' => [
@@ -204,10 +265,14 @@ return [
         'icon' => 'shield-exclamation',
         'queue_keywords' => ['oncol', 'cancer', 'chemo'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
+        'roles' => ['oncologist'],
         'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse', 'pharmacist'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'view_roles' => [
+            'oncologist', 'general_physician', 'doctor', 'pharmacist',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'pharmacist',
+        ],
         'specialist_keywords' => ['oncol', 'cancer', 'chemo'],
     ],
     'renal' => [
@@ -221,10 +286,12 @@ return [
         'icon' => 'circle-stack',
         'queue_keywords' => ['renal', 'dialysis', 'nephro', 'kidney'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
-        'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'roles' => ['dialysis_nurse'],
+        'support_roles' => [],
+        'view_roles' => [
+            'dialysis_nurse', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['renal', 'nephro', 'dialysis', 'kidney'],
     ],
     'surgery' => [
@@ -238,10 +305,12 @@ return [
         'icon' => 'wrench-screwdriver',
         'queue_keywords' => ['surg', 'theatre', 'operat', 'pre-op'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
-        'support_roles' => ['nurse'],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'roles' => ['surgeon', 'theatre_nurse'],
+        'support_roles' => [],
+        'view_roles' => [
+            'surgeon', 'theatre_nurse', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['surg', 'theatre', 'operat'],
     ],
     'vaccination' => [
@@ -255,7 +324,11 @@ return [
         'icon' => 'shield-check',
         'queue_keywords' => ['vaccin', 'immun', 'epi', 'injection'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['general_physician', 'doctor', 'nurse'],
+        'view_roles' => [
+            'general_physician', 'doctor', 'nurse', 'receptionist',
+        ],
+        'refer_roles' => ['general_physician', 'doctor', 'receptionist'],
         'specialist_keywords' => ['vaccin', 'immun', 'epi'],
     ],
     'pathology' => [
@@ -269,7 +342,18 @@ return [
         'icon' => 'document-magnifying-glass',
         'queue_keywords' => ['pathol', 'histo', 'cytol', 'biopsy'],
         'access' => 'general',
-        'roles' => ['lab_technician', 'doctor', 'nurse', 'receptionist'],
+        'roles' => [
+            'lab_technician', 'lab_manager', 'pathologist',
+            'emergency_physician', 'ed_nurse', 'surgeon',
+        ],
+        'view_roles' => [
+            'lab_technician', 'lab_manager', 'pathologist',
+            'emergency_physician', 'ed_nurse', 'surgeon',
+            'general_physician', 'doctor',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor',
+        ],
         'specialist_keywords' => ['pathol', 'histo', 'cytol'],
     ],
     'infusion' => [
@@ -283,7 +367,13 @@ return [
         'icon' => 'beaker',
         'queue_keywords' => ['infusion', 'iv', 'drip', 'day care'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'pharmacist', 'receptionist'],
+        'roles' => ['oncologist', 'nurse'],
+        'view_roles' => [
+            'oncologist', 'nurse', 'general_physician', 'doctor', 'pharmacist',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'pharmacist',
+        ],
         'specialist_keywords' => ['infusion', 'iv therapy', 'day care'],
     ],
     'dermatology' => [
@@ -297,10 +387,12 @@ return [
         'icon' => 'swatch',
         'queue_keywords' => ['derma', 'skin', 'rash'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
+        'roles' => ['dermatologist', 'general_physician', 'doctor'],
         'support_roles' => [],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'view_roles' => [
+            'dermatologist', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['derma', 'skin'],
     ],
     'podiatry' => [
@@ -314,10 +406,12 @@ return [
         'icon' => 'finger-print',
         'queue_keywords' => ['podiat', 'foot', 'diabetic foot'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
+        'roles' => ['podiatrist'],
         'support_roles' => [],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'view_roles' => [
+            'podiatrist', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['podiat', 'foot'],
     ],
     'fertility' => [
@@ -331,10 +425,12 @@ return [
         'icon' => 'sparkles',
         'queue_keywords' => ['fertil', 'ivf', 'reproduct'],
         'access' => 'restricted',
-        'roles' => ['doctor'],
+        'roles' => ['fertility_specialist'],
         'support_roles' => [],
-        'view_roles' => ['doctor', 'general_physician', 'nurse'],
-        'refer_roles' => ['doctor', 'general_physician', 'nurse'],
+        'view_roles' => [
+            'fertility_specialist', 'general_physician', 'doctor',
+        ],
+        'refer_roles' => ['general_physician', 'doctor'],
         'specialist_keywords' => ['fertil', 'ivf', 'reproduct'],
     ],
     'child_welfare' => [
@@ -348,7 +444,11 @@ return [
         'icon' => 'gift',
         'queue_keywords' => ['cwc', 'child welfare', 'well baby', 'well-child', 'welfare clinic'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['general_physician', 'doctor', 'nurse'],
+        'view_roles' => [
+            'general_physician', 'doctor', 'nurse', 'receptionist',
+        ],
+        'refer_roles' => ['general_physician', 'doctor', 'receptionist'],
         // Prefer multi-word / CWC stems — do not use bare "child" (steals pediatrics).
         'specialist_keywords' => ['child welfare', 'cwc', 'welfare clinic', 'well baby', 'well-child'],
     ],
@@ -364,7 +464,13 @@ return [
         // Avoid ED stems (emergency, casualty, trauma, er, a&e) — those belong to emergency.
         'queue_keywords' => ['ambulance', 'ems', 'paramedic', 'prehospital', 'ambulance service'],
         'access' => 'general',
-        'roles' => ['doctor', 'nurse', 'receptionist'],
+        'roles' => ['ambulance_staff'],
+        'view_roles' => [
+            'ambulance_staff', 'general_physician', 'doctor', 'receptionist',
+        ],
+        'refer_roles' => [
+            'general_physician', 'doctor', 'receptionist',
+        ],
         'specialist_keywords' => ['ambulance', 'ems', 'paramedic', 'prehospital'],
     ],
 ];
diff --git a/tests/Feature/CareNurseOrgAccessTest.php b/tests/Feature/CareNurseOrgAccessTest.php
index b395014..96c842b 100644
--- a/tests/Feature/CareNurseOrgAccessTest.php
+++ b/tests/Feature/CareNurseOrgAccessTest.php
@@ -123,7 +123,7 @@ class CareNurseOrgAccessTest extends TestCase
             'owner_ref' => $owner->public_id,
             'organization_id' => $employer->id,
             'user_ref' => strtolower($nurse->email),
-            'role' => 'nurse',
+            'role' => 'ed_nurse',
         ]);
 
         $branch = Branch::create([
@@ -195,7 +195,7 @@ class CareNurseOrgAccessTest extends TestCase
 
         $nurse = User::create([
             'public_id' => 'er-docs-nurse',
-            'name' => 'Nurse',
+            'name' => 'ED Nurse',
             'email' => 'er-docs-nurse@example.com',
         ]);
 
@@ -222,7 +222,7 @@ class CareNurseOrgAccessTest extends TestCase
             'owner_ref' => $owner->public_id,
             'organization_id' => $organization->id,
             'user_ref' => $nurse->public_id,
-            'role' => 'nurse',
+            'role' => 'ed_nurse',
         ]);
 
         $branch = Branch::create([
@@ -299,8 +299,8 @@ class CareNurseOrgAccessTest extends TestCase
 
         $organization = Organization::create([
             'owner_ref' => $owner->public_id,
-            'name' => 'Cardio Clinic',
-            'slug' => 'cardio-docs-clinic',
+            'name' => 'Rad Clinic',
+            'slug' => 'rad-docs-clinic',
             'settings' => [
                 'onboarded' => true,
                 'plan' => 'pro',
@@ -330,9 +330,9 @@ class CareNurseOrgAccessTest extends TestCase
         ]);
 
         $modules = app(SpecialtyModuleService::class);
-        $modules->activate($organization, $owner->public_id, 'cardiology');
+        $modules->activate($organization, $owner->public_id, 'radiology');
 
-        $dept = Department::query()->where('type', 'cardiology')->where('branch_id', $branch->id)->firstOrFail();
+        $dept = Department::query()->where('type', 'radiology')->where('branch_id', $branch->id)->firstOrFail();
 
         $patient = Patient::create([
             'owner_ref' => $owner->public_id,
@@ -369,11 +369,12 @@ class CareNurseOrgAccessTest extends TestCase
         ]);
 
         $labMember = Member::query()->where('user_ref', $lab->public_id)->firstOrFail();
-        $this->assertSame('view', $modules->memberAccessLevel($organization, $labMember, 'cardiology'));
+        // Lab manages pathology/blood bank; radiology is view-only.
+        $this->assertSame('view', $modules->memberAccessLevel($organization, $labMember, 'radiology'));
 
         $this->actingAs($lab)
             ->get(route('care.specialty.workspace', [
-                'module' => 'cardiology',
+                'module' => 'radiology',
                 'visit' => $visit,
                 'tab' => 'documents',
             ]))
diff --git a/tests/Feature/CareSpecialtyAccessTest.php b/tests/Feature/CareSpecialtyAccessTest.php
index 622bc2c..cc6e23a 100644
--- a/tests/Feature/CareSpecialtyAccessTest.php
+++ b/tests/Feature/CareSpecialtyAccessTest.php
@@ -95,22 +95,40 @@ class CareSpecialtyAccessTest extends TestCase
 
     public function test_nurse_and_pharmacist_manage_general_modules(): void
     {
+        foreach (['vaccination', 'child_welfare', 'maternity'] as $key) {
+            $this->modules->activate($this->organization->fresh(), $this->owner->public_id, $key);
+        }
+        $this->organization->refresh();
+
         [, $nurse] = $this->makeStaff('nurse', 'nurse1');
         [, $edNurse] = $this->makeStaff('ed_nurse', 'edn1');
         [, $pharmacist] = $this->makeStaff('pharmacist', 'rx1');
         [, $lab] = $this->makeStaff('lab_technician', 'lab1');
+        [, $receptionist] = $this->makeStaff('receptionist', 'rec1');
 
-        // Legacy nurse is limited — no specialty modules.
+        // Legacy floor nurse: vaccination / CWC / infusion / maternity manage; emergency refer only.
         $this->assertFalse($this->modules->memberCanManage($this->organization, $nurse, 'emergency'));
+        $this->assertTrue($this->modules->memberCanRefer($this->organization, $nurse, 'emergency'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $nurse, 'vaccination'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $nurse, 'infusion'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $nurse, 'maternity'));
         // ED nurse matrix apps: Emergency, Blood Bank, Radiology, Pathology.
         $this->assertTrue($this->modules->memberCanManage($this->organization, $edNurse, 'emergency'));
         $this->assertTrue($this->modules->memberCanManage($this->organization, $edNurse, 'pathology'));
-        // Pharmacist is pharmacy-only (core app) — no specialty modules.
+        // Pharmacist: no specialty manage; refer/view pharmacy-adjacent modules.
         $this->assertFalse($this->modules->memberCanManage($this->organization, $pharmacist, 'emergency'));
         $this->assertFalse($this->modules->memberCanManage($this->organization, $pharmacist, 'infusion'));
-        $this->assertTrue($this->modules->memberCanManage($this->organization, $lab, 'pathology'));
-        $this->assertFalse($this->modules->memberCanManage($this->organization, $lab, 'blood_bank'));
+        $this->assertTrue($this->modules->memberCanRefer($this->organization, $pharmacist, 'infusion'));
+        $this->assertTrue($this->modules->memberCanView($this->organization, $pharmacist, 'emergency'));
         $this->assertFalse($this->modules->memberCanManage($this->organization, $pharmacist, 'cardiology'));
+        // Lab: pathology + blood bank manage; radiology view.
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $lab, 'pathology'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $lab, 'blood_bank'));
+        $this->assertSame('view', $this->modules->memberAccessLevel($this->organization, $lab, 'radiology'));
+        // Receptionist: refer only (no specialty manage).
+        $this->assertFalse($this->modules->memberCanManage($this->organization, $receptionist, 'emergency'));
+        $this->assertTrue($this->modules->memberCanRefer($this->organization, $receptionist, 'emergency'));
+        $this->assertTrue($this->modules->memberCanRefer($this->organization, $receptionist, 'dentistry'));
     }
 
     public function test_gp_doctor_manages_general_but_only_views_restricted(): void
@@ -129,17 +147,33 @@ class CareSpecialtyAccessTest extends TestCase
 
         $this->assertFalse($this->modules->isDeskSpecialist($this->organization, $member));
         $this->assertTrue($this->modules->memberCanManage($this->organization, $member, 'emergency'));
-        // Dentistry is not a GP primary app.
+        // Dentistry is not a GP primary app — refer only.
         $this->assertFalse($this->modules->memberCanManage($this->organization, $member, 'dentistry'));
-        // Cardiology is a GP primary app (manage).
+        $this->assertTrue($this->modules->memberCanRefer($this->organization, $member, 'dentistry'));
+        // Cardiology / ophthalmology are GP primary apps (manage).
         $this->assertTrue($this->modules->memberCanManage($this->organization, $member, 'cardiology'));
-        // Psychiatry is outside GP apps — refer/view via legacy config for GP.
+        $this->modules->activate($this->organization->fresh(), $this->owner->public_id, 'ophthalmology');
+        $this->organization->refresh();
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $member, 'ophthalmology'));
+        // Psychiatry is outside GP manage — refer/view via roleReferApps.
         $this->assertFalse($this->modules->memberCanManage($this->organization, $member, 'psychiatry'));
         $this->assertTrue($this->modules->memberCanView($this->organization, $member, 'psychiatry'));
         $this->assertTrue($this->modules->memberCanRefer($this->organization, $member, 'psychiatry'));
         $this->assertSame('refer', $this->modules->memberAccessLevel($this->organization, $member, 'psychiatry'));
     }
 
+    public function test_dedicated_cardiologist_role_manages_cardiology_only(): void
+    {
+        [, $member] = $this->makeStaff('cardiologist', 'cardio-role');
+
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $member, 'cardiology'));
+        $this->assertSame('manage', $this->modules->memberAccessLevel($this->organization, $member, 'cardiology'));
+        $this->assertSame('none', $this->modules->memberAccessLevel($this->organization, $member, 'emergency'));
+        $this->assertSame('none', $this->modules->memberAccessLevel($this->organization, $member, 'dentistry'));
+        $this->assertTrue(app(\App\Services\Care\CarePermissions::class)->isSingleAppSpecialist($member));
+        $this->assertFalse($this->modules->shouldShowSpecialtyNav($this->organization, $member));
+    }
+
     public function test_cardiologist_manages_restricted_cardiology(): void
     {
         [$doctor, $member] = $this->makeStaff('doctor', 'cardio1');
@@ -237,7 +271,7 @@ class CareSpecialtyAccessTest extends TestCase
             ->assertSee('>Specialty</p>', false)
             ->assertSee('Emergency')
             ->assertSee('Cardiology')
-            ->assertDontSee('Dentistry');
+            ->assertSee('Dentistry'); // GP refer access
     }
 
     public function test_dentistry_specialty_does_not_match_ent_keyword(): void
@@ -382,9 +416,11 @@ class CareSpecialtyAccessTest extends TestCase
             ->pluck('key')
             ->all();
 
-        // Pharmacist: pharmacy core only — no specialty modules.
-        $this->assertSame([], $enabledForPharmacist);
-        $this->assertFalse($this->modules->shouldShowSpecialtyNav($this->organization, $pharmacistMember));
+        // Pharmacist: pharmacy-adjacent specialty refer/view (multi-app → Specialty nav).
+        $this->assertContains('emergency', $enabledForPharmacist);
+        $this->assertContains('infusion', $enabledForPharmacist);
+        $this->assertNotContains('cardiology', $enabledForPharmacist);
+        $this->assertTrue($this->modules->shouldShowSpecialtyNav($this->organization, $pharmacistMember));
 
         $this->assertContains('emergency', $enabledForEp);
         $this->assertContains('radiology', $enabledForEp);
@@ -394,7 +430,7 @@ class CareSpecialtyAccessTest extends TestCase
         $this->actingAs($pharmacistUser)
             ->get(route('care.dashboard'))
             ->assertOk()
-            ->assertDontSee('>Specialty</p>', false);
+            ->assertSee('>Specialty</p>', false);
     }
 
     public function test_manage_role_still_sees_mutate_actions_on_restricted_module(): void
@@ -778,8 +814,18 @@ class CareSpecialtyAccessTest extends TestCase
         $this->assertTrue($permissions->can($lab, 'lab.manage'));
         $this->assertTrue($permissions->can($lab, 'pathology.result.enter'));
         $this->assertFalse($permissions->can($lab, 'pathology.result.approve'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $lab, 'blood_bank'));
         $this->assertTrue($permissions->can($labMgr, 'pathology.result.approve'));
         $this->assertTrue($permissions->can($labMgr, 'lab.catalog.manage'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $labMgr, 'blood_bank'));
+
+        [, $cardiologist] = $this->makeStaff('cardiologist', 'matrix-cardio');
+        [, $ophthalmologist] = $this->makeStaff('ophthalmologist', 'matrix-oph');
+        $this->modules->activate($this->organization->fresh(), $this->owner->public_id, 'ophthalmology');
+        $this->organization->refresh();
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $cardiologist, 'cardiology'));
+        $this->assertFalse($this->modules->memberCanManage($this->organization, $cardiologist, 'emergency'));
+        $this->assertTrue($this->modules->memberCanManage($this->organization, $ophthalmologist, 'ophthalmology'));
 
         $this->assertTrue($permissions->can($billing, 'bills.manage'));
         $this->assertFalse($permissions->can($billing, 'payments.manage'));
diff --git a/tests/Feature/CareSpecialtyClinicalTest.php b/tests/Feature/CareSpecialtyClinicalTest.php
index f90e522..7261d23 100644
--- a/tests/Feature/CareSpecialtyClinicalTest.php
+++ b/tests/Feature/CareSpecialtyClinicalTest.php
@@ -54,7 +54,7 @@ class CareSpecialtyClinicalTest extends TestCase
             'owner_ref' => $this->owner->public_id,
             'organization_id' => $this->organization->id,
             'user_ref' => $this->owner->public_id,
-            'role' => 'nurse',
+            'role' => 'hospital_admin',
         ]);
 
         $this->branch = Branch::create([
diff --git a/tests/Feature/CareSpecialtyModulesTest.php b/tests/Feature/CareSpecialtyModulesTest.php
index a8d7249..6606ee9 100644
--- a/tests/Feature/CareSpecialtyModulesTest.php
+++ b/tests/Feature/CareSpecialtyModulesTest.php
@@ -216,16 +216,16 @@ class CareSpecialtyModulesTest extends TestCase
         Http::fake();
         app(SpecialtyModuleService::class)->activate($this->organization, $this->owner->public_id, 'dentistry');
 
-        $nurse = User::create([
-            'public_id' => 'modules-nurse',
-            'name' => 'Floor Nurse',
-            'email' => 'modules-nurse@example.com',
+        $receptionist = User::create([
+            'public_id' => 'modules-reception',
+            'name' => 'Front Desk',
+            'email' => 'modules-reception@example.com',
         ]);
         Member::create([
             'owner_ref' => $this->owner->public_id,
             'organization_id' => $this->organization->id,
-            'user_ref' => $nurse->public_id,
-            'role' => 'nurse',
+            'user_ref' => $receptionist->public_id,
+            'role' => 'receptionist',
             'branch_id' => $this->branch->id,
         ]);
 
@@ -234,7 +234,8 @@ class CareSpecialtyModulesTest extends TestCase
             ->assertOk()
             ->assertSee('Patient flow');
 
-        $this->actingAs($nurse)
+        // Receptionist has refer access to dentistry (registration into specialty queues).
+        $this->actingAs($receptionist)
             ->get(route('care.specialty.show', 'dentistry'))
             ->assertOk()
             ->assertSee('Patient flow');
diff --git a/tests/Feature/CareSpecialtyShellTest.php b/tests/Feature/CareSpecialtyShellTest.php
index 3bb5aea..ccb2130 100644
--- a/tests/Feature/CareSpecialtyShellTest.php
+++ b/tests/Feature/CareSpecialtyShellTest.php
@@ -55,7 +55,7 @@ class CareSpecialtyShellTest extends TestCase
             'owner_ref' => $this->owner->public_id,
             'organization_id' => $this->organization->id,
             'user_ref' => $this->owner->public_id,
-            'role' => 'nurse',
+            'role' => 'dentist',
         ]);
 
         $this->branch = Branch::create([
@@ -99,6 +99,8 @@ class CareSpecialtyShellTest extends TestCase
 
     public function test_specialty_shell_overview_and_sections_render(): void
     {
+        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'emergency_physician']);
+
         app(SpecialtyModuleService::class)->activate(
             $this->organization,
             $this->owner->public_id,
@@ -153,6 +155,8 @@ class CareSpecialtyShellTest extends TestCase
 
     public function test_workspace_can_add_catalog_service_to_visit_bill(): void
     {
+        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'emergency_physician']);
+
         app(SpecialtyModuleService::class)->activate(
             $this->organization,
             $this->owner->public_id,
@@ -307,7 +311,7 @@ class CareSpecialtyShellTest extends TestCase
 
     public function test_workspace_includes_timeline_tab_and_complete_action(): void
     {
-        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'doctor']);
+        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'dentist']);
 
         app(SpecialtyModuleService::class)->activate(
             $this->organization,
@@ -393,7 +397,7 @@ class CareSpecialtyShellTest extends TestCase
 
     public function test_called_workspace_shows_call_again_until_session_starts(): void
     {
-        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'doctor']);
+        Member::query()->where('user_ref', $this->owner->public_id)->update(['role' => 'dentist']);
 
         app(SpecialtyModuleService::class)->activate(
             $this->organization,