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The Rise And Impact Of Nurse Practitioners And Physician Assistants On Their Own And Cross‐Occupation Incomes

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  • JOHN J. PERRY

Abstract

There has been a dramatic increase in the authority granted to nurse practitioners (NP) and physician assistants (PA). This “expanded” authority has changed who can provide health‐care services and has weakened the control physicians have traditionally held over the provision of medical services. These changes in regulation have varied by occupation, state, and year and provide variation that can be exploited to empirically measure the individual and collective impacts of changes in NP authority and PA authority on practitioner incomes. It is found that changes in NP and PA regulatory authority do impact the labor markets of all three practitioner categories. NPs having greater practice authority brings physician incomes down, has differential impacts on PA incomes, and improves their own earnings, other factors held constant. PAs having increased authority has a downward effect on NP earnings, a positive impact on physician income, and little impact on their own incomes. (JEL I18, J18, J44, H75)

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  • John J. Perry, 2009. "The Rise And Impact Of Nurse Practitioners And Physician Assistants On Their Own And Cross‐Occupation Incomes," Contemporary Economic Policy, Western Economic Association International, vol. 27(4), pages 491-511, October.
    • Handle: RePEc:bla:coecpo:v:27:y:2009:i:4:p:491-511
    DOI: 10.1111/j.1465-7287.2009.00162.x
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    Cited by:

    1. Timmons, Edward Joseph, 2017. "The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care," Health Policy, Elsevier, vol. 121(2), pages 189-196.
    2. McMichael, Benjamin, 2017. "Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants," Working Papers 07538, George Mason University, Mercatus Center.
    3. Guo, Jiapei & Kilby, Angela E. & Marks, Mindy S., 2024. "The impact of scope-of-practice restrictions on access to medical care," Journal of Health Economics, Elsevier, vol. 94(C).
    4. Shishir Shakya & Joshua K. Bedi & Alicia Plemmons, 2024. "Healthcare Workforce Shortages and Job Autonomy: Nurse Practitioners and Entrepreneurship in the United States," Working Papers 24-08, Department of Economics, Appalachian State University.
    5. Patricia Pittman & Benjamin Williams, 2012. "Physician Wages in States with Expanded APRN Scope of Practice," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-5, February.
    6. Peter T. Leeson & Henry A. Thompson, 2023. "Public choice and public health," Public Choice, Springer, vol. 195(1), pages 5-41, April.
    7. Benjamin J. McMichael, 2017. "The Demand for Healthcare Regulation: The Effect of Political Spending on Occupational Licensing Laws," Southern Economic Journal, John Wiley & Sons, vol. 84(1), pages 297-316, July.
    8. Kamyar Nasseh & John R. Bowblis & Coady Wing, 2024. "How do dental practices respond to changes in scope of practice regulations?," Health Economics, John Wiley & Sons, Ltd., vol. 33(11), pages 2508-2524, November.
    9. Shishir Shakya & Alicia Plemmons, 2020. "Does Scope of Practice Affect Mobility of Nurse Practitioners Serving Medicare Beneficiaries?," Journal of Labor Research, Springer, vol. 41(4), pages 421-434, December.
    10. Tammy O’Rourke & Joseph Kirk & Elsie Duff & Richard Golonka, 2019. "A survey of nurse practitioner controlled drugs and substances prescribing in three Canadian provinces," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4342-4356, December.
    11. Jie Chen & Chad D. Meyerhoefer & Edward J. Timmons, 2024. "The effects of dental hygienist autonomy on dental care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1726-1747, August.
    12. John J. Perry, 2012. "State-Granted Practice Authority: Do Nurse Practitioners Vote with Their Feet?," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-5, November.
    13. Morris M. Kleiner, 2016. "Battling over Jobs: Occupational Licensing in Health Care," American Economic Review, American Economic Association, vol. 106(5), pages 165-170, May.
    14. Roman V. Galperin, 2020. "Organizational Powers: Contested Innovation and Loss of Professional Jurisdiction in the Case of Retail Medicine," Organization Science, INFORMS, vol. 31(2), pages 508-534, March.

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    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare

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