IDEAS home Printed from https://ideas.repec.org/a/bla/coecpo/v27y2009i4p491-511.html
   My bibliography  Save this article

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

Author

Listed:
  • 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)

Suggested Citation

  • 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
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/j.1465-7287.2009.00162.x
    Download Restriction: no
    File URL: https://libkey.io/10.1111/j.1465-7287.2009.00162.x?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. James J. Heckman, 1976. "The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models," NBER Chapters, in: Annals of Economic and Social Measurement, Volume 5, number 4, pages 475-492, National Bureau of Economic Research, Inc.
    2. Hausman, Jerry, 2015. "Specification tests in econometrics," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 112-134.
    3. Kennedy, Peter E, 1981. "Estimation with Correctly Interpreted Dummy Variables in Semilogarithmic Equations [The Interpretation of Dummy Variables in Semilogarithmic Equations]," American Economic Review, American Economic Association, vol. 71(4), pages 801-801, September.
    4. David E. Kalist & Stephen J. Spurr, 2004. "The Effect of State Laws on the Supply of Advanced Practice Nurses," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 271-281, December.
    5. Michael Dueker & Ada Jacox & David Kalist & Stephen Spurr, 2005. "The Practice Boundaries of Advanced Practice Nurses: An Economic and Legal Analysis," Journal of Regulatory Economics, Springer, vol. 27(3), pages 309-330, January.
    6. Sass, Tim R & Nichols, Mark W, 1996. "Scope-of-Practice Regulation: Physician Control and the Wages of Non-Physician Health-Care Professionals," Journal of Regulatory Economics, Springer, vol. 9(1), pages 61-81, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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).
    11. Peter T. Leeson & Henry A. Thompson, 2023. "Public choice and public health," Public Choice, Springer, vol. 195(1), pages 5-41, April.
    12. 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.
    13. 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.
    14. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Stange, Kevin, 2014. "How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants," Journal of Health Economics, Elsevier, vol. 33(C), pages 1-27.
    2. Ichimura, Hidehiko & Todd, Petra E., 2007. "Implementing Nonparametric and Semiparametric Estimators," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 6, chapter 74, Elsevier.
    3. Verbeek, M.J.C.M. & Nijman, T.E., 1992. "Incomplete panels and selection bias : A survey," Discussion Paper 1992-7, Tilburg University, Center for Economic Research.
    4. Philippe Cyrenne & Robert Fenton & Joseph Warbanski, 2006. "Historic Buildings and Rehabilitation Expenditures: A Panel Data Approach," Journal of Real Estate Research, Taylor & Francis Journals, vol. 28(4), pages 349-380, January.
    5. Marta Ruiz-Arranz & Benjamin Davis & Marco Stampini & Paul Winters & Sudhanshu Handa, 2002. "More Calories or More Diversity? An econometric evaluation of the impact of the PROGRESA and PROCAMPO transfer programmes on food security in rural Mexico," Working Papers 02-09, Agricultural and Development Economics Division of the Food and Agriculture Organization of the United Nations (FAO - ESA).
    6. VILHUBERT, Lars, 1999. "Wage Flexibility and Contract Structure in Germany," Cahiers de recherche 9905, Universite de Montreal, Departement de sciences economiques.
    7. Sloczynski, Tymon, 2018. "A General Weighted Average Representation of the Ordinary and Two-Stage Least Squares Estimands," IZA Discussion Papers 11866, Institute of Labor Economics (IZA).
    8. Solomon Asfaw & Dagmar Mithöfer & Hermann Waibel, 2010. "Agrifood supply chain, private‐sector standards, and farmers' health: evidence from Kenya," Agricultural Economics, International Association of Agricultural Economists, vol. 41(3‐4), pages 251-263, May.
    9. Fors, Gunnar & Svensson, Roger, 2002. "R&D and foreign sales in Swedish multinationals: a simultaneous relationship?," Research Policy, Elsevier, vol. 31(1), pages 95-107, January.
    10. Brownstone, David, 1997. "Multiple Imputation Methodology for Missing Data, Non-Random Response, and Panel Attrition," University of California Transportation Center, Working Papers qt2zd6w6hh, University of California Transportation Center.
    11. Mario D. Tello, 2020. "Political Economy Approach of Trade Barriers: The Case of Peruvian’s Trade Liberalization," Documentos de Trabajo / Working Papers 2020-486, Departamento de Economía - Pontificia Universidad Católica del Perú.
    12. Kuester, Sabine & Homburg, Christian & Hildesheim, Andreas, 2017. "The catbird seat of the sales force: How sales force integration leads to new product success," International Journal of Research in Marketing, Elsevier, vol. 34(2), pages 462-479.
    13. Ertugrul Uysal & Sascha Alavi & Valéry Bezençon, 2022. "Trojan horse or useful helper? A relationship perspective on artificial intelligence assistants with humanlike features," Journal of the Academy of Marketing Science, Springer, vol. 50(6), pages 1153-1175, November.
    14. Stephan F. Gohmann, 2005. "Preventive Care And Insurance Coverage," Contemporary Economic Policy, Western Economic Association International, vol. 23(4), pages 513-528, October.
    15. Nawata, Kazumitsu & McAleer, Michael, 2014. "The maximum number of parameters for the Hausman test when the estimators are from different sets of equations," Economics Letters, Elsevier, vol. 123(3), pages 291-294.
    16. Miguel Bacharach & William J. Vaughan, 1994. "Household Water Demand Estimation," IDB Publications (Working Papers) 25218, Inter-American Development Bank.
    17. Matteo, PICCHIO, 2006. "Wage Differentials and Temporary Jobs in Italy," Discussion Papers (ECON - Département des Sciences Economiques) 2006033, Université catholique de Louvain, Département des Sciences Economiques.
    18. Xiaodong Teng & Bao-Guang Chang & Kun-Shan Wu, 2021. "The Role of Financial Flexibility on Enterprise Sustainable Development during the COVID-19 Crisis—A Consideration of Tangible Assets," Sustainability, MDPI, vol. 13(3), pages 1-16, January.
    19. Valizadeh, Pourya & Ng, Shu Wen, 2020. "The New school food standards and nutrition of school children: Direct and Indirect Effect Analysis," Economics & Human Biology, Elsevier, vol. 39(C).
    20. Choi, Woon Gyu, 1999. "Estimating the Discount Rate Policy Reaction Function of the Monetary Authority," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 14(4), pages 379-401, July-Aug..

    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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:coecpo:v:27:y:2009:i:4:p:491-511. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://edirc.repec.org/data/weaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.