title: Trends in state regulation of nurse practitioners and physician assistants, 2001 to 2010.
abstract: Nurse practitioners and physician assistants can alleviate some of the primary care shortage facing the United States, but their scope-of-practice is limited by state regulation. This study reports both cross-sectional and longitudinal trends in state scope-of-practice regulations for nurse practitioners and physician assistants over a 10-year period. Regulations from 2001 to 2010 were compiled and described with respect to entry-to-practice standards, physician involvement in treatment/diagnosis, prescriptive authority, and controlled substances. Findings indicate that most states loosened regulations, granting greater autonomy to nurse practitioners and physician assistants, particularly with respect to prescriptive authority and physician involvement in treatment and diagnosis. Many states also increased barriers to entry, requiring high levels of education before entering practice. Knowledge of state trends in nurse practitioner and physician assistant regulation should inform current efforts to standardize scope-of-practice nationally.
authors.affiliation: University of Massachusetts Boston, MA, USA emily.gadbois001@umb.edu.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Gadbois
authors.affiliation: University of Massachusetts Boston, MA, USA.
authors.forename: Edward Alan
authors.initials: EA
authors.lastname: Miller
authors.affiliation: Providence VA Medical Center, Providence, RI, USA Brown University School of Public Health, Providence, RI, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Tyler
authors.affiliation: Canandaigua VA Medical Center, Canandaigua, NY, USA University of Rochester, Rochester, NY, USA.
authors.forename: Orna
authors.initials: O
authors.lastname: Intrator
mesh_terms: D005260:Female; D033161:Government Regulation; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000331:legislation & jurisprudence*; D010823:Physician Assistants / Q000331:legislation & jurisprudence*; D024382:Professional Role; D013219:State Government
keywords: nurse practitioners; physician assistants; primary care; public policy; workforce