Scope-of-Practice Regulations and Physician Assistant Inter-State Practice Relocation

Tulasiram Nepal () and Shishir Shakya ()
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Tulasiram Nepal: The University of Memphis
Shishir Shakya: Appalachian State University

Journal of Labor Research, 2025, vol. 46, issue 1, No 2, 32-51

Abstract: Abstract Scope-of-practice laws serve as state-specific restrictions dictating the range of services nonphysician healthcare providers can deliver to their patients. While certain states allow physician assistants the optimal scope-of-practice latitude to practice in accordance with their full medical education and training, other states impose stringent limitations, mandating varying degrees of supervision by physicians. We examine the impact of scope-of-practice regulations on the propensity for interstate practice relocation of physician assistants. Our findings reveal that physician assistants exhibit $$\approx 3\%$$ ≈ 3 % higher likelihood of relocating within optimal scope-of-practice. Furthermore, optimal scope-of-practice enhances the retention of physician assistants in rural areas more than in non-rural areas, suggesting increased access to care in rural regions. We also provide state-by-year accounting of physician assistants, including aggregates such as non-movers, total movers, intra-state movers, interstate movers, new entrants, and exits. This level of detailed accounting is not available in existing literature.

Keywords: Scope-of-practice; Regulations; Physician assistant (search for similar items in EconPapers)
JEL-codes: I10 I11 I18 J44 J61 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s12122-025-09371-6

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