To Practice or Not to Practice: Developing State Law and Policy on Physician Assistants

Presented in this paper is an analysis of the regulations for physician assistants promulgated by state administrative agencies, usually the board of medical examiners, pursuant to statutory authority. These regulations represent a further step in the evolution of state policy concerning this new health manpower occupation. Although there is considerable variability in the regulatory approaches that have been adopted to date, the paper points out certain provisions that may especially inhibit or facilitate the wide utilization of the physician assistant. Notwithstanding certain excellent provisions found in some of the states' rules and regulations, there does not appear to be, at this time, a model regulatory system. Primary attention of the paper is focused on those regulatory issues that have most immediate and direct bearing on the education and employment of physician assistants. These include approval of training programs, job description requirements, approval of the supervising physician, supervision of the physician assistant, mechanisms for assuring continued competence, and disciplinary procedures. In addition, certain recommendations are made that would encourage greater uniformity in the state regulations.