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The Practice Boundaries of Advanced Practice Nurses: An Economic and Legal Analysis

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  • Michael Dueker
  • Ada Jacox
  • David Kalist

    ()

  • Stephen Spurr

    ()

Abstract

The purpose of this study is to examine the effects of State regulation that determines the extent of professional independence of advanced practice nurses (APNs). We find that in States where APNs have acquired a substantial amount of professional independence, the earnings of APNs are substantially lower, and those of physicians’ assistants (PAs) are substantially higher, than in other States. These results are striking since PAs are in direct competition with APNs; the only real operational difference between these groups is that PAs are salaried employees who must work under the supervision of a physician. The implication is that physicians have responded to an increase in professional independence of APNs by hiring fewer APNs and more PAs. The finding that earnings of APNs decline when they attain more professional autonomy vis-à-vis physicians reinforces work by Sass and Nichols on physical therapists. Copyright Springer 2005

Suggested Citation

  • 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.
  • Handle: RePEc:kap:regeco:v:27:y:2005:i:3:p:309-330 DOI: 10.1007/s11149-005-6626-3
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    References listed on IDEAS

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    7. Edward J. Schumacher & Barry T. Hirsch, 1997. "Compensating Differentials and Unmeasured Ability in the Labor Market for Nurses: Why Do Hospitals Pay More?," ILR Review, Cornell University, ILR School, vol. 50(4), pages 557-579, July.
    8. Stephen T. Mennemeyer & Gary Gaumer, 1983. "Nursing Wages and the Value of Educational Credentials," Journal of Human Resources, University of Wisconsin Press, vol. 18(1), pages 32-48.
    9. Edward J. Schumacher, "undated". "Relative Wages and the Returns to Education in the Labor Market for Registered Nurses," Working Papers 9720, East Carolina University, Department of Economics.
    10. 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.
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    Cited by:

    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. 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.
    3. Morris M. Kleiner & Allison Marier & Kyoung Won Park & Coady Wing, 2016. "Relaxing Occupational Licensing Requirements: Analyzing Wages and Prices for a Medical Service," Journal of Law and Economics, University of Chicago Press, vol. 59(2), pages 261-291.
    4. William H. Greene & David A. Hensher, 2008. "Modeling Ordered Choices: A Primer and Recent Developments," Working Papers 08-26, New York University, Leonard N. Stern School of Business, Department of Economics.
    5. Park, Jee-Hyeong & Spurr, Stephen J. & Chang, Sheng-Kai, 2009. "A Model of Hierarchical Professionals: Cooperation and Conflict between Anesthesiologists and CRNAs," CEI Working Paper Series 2009-13, Center for Economic Institutions, Institute of Economic Research, Hitotsubashi University.
    6. Alexander, Diane & Schnell, Molly, 2016. "Just What the Nurse Practitioner Ordered: Independent Prescriptive Authority and Population Mental Health," Working Paper Series WP-2017-8, Federal Reserve Bank of Chicago.

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    Keywords

    regulation; professions; nursing; panel data;

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