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Scope-of-Practice Regulations and Physician Assistant Inter-State Practice Relocation

Author

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  • Tulasiram Nepal

    (The University of Memphis)

  • Shishir Shakya

    (Appalachian State University)

Abstract

Scope-of-practice laws serve as state-specific restrictions dictating the range of services nonphysician healthcare providers can deliver to their patients. While certain states allow physician assistants the optimal scope-of-practice latitude to practice in accordance with their full medical education and training, other states impose stringent limitations, mandating varying degrees of supervision by physicians. We examine the impact of scope-of-practice regulations on the propensity for interstate practice relocation of physician assistants. Our findings reveal that physician assistants exhibit $$\approx 3\%$$ ≈ 3 % higher likelihood of relocating within optimal scope-of-practice. Furthermore, optimal scope-of-practice enhances the retention of physician assistants in rural areas more than in non-rural areas, suggesting increased access to care in rural regions. We also provide state-by-year accounting of physician assistants, including aggregates such as non-movers, total movers, intra-state movers, interstate movers, new entrants, and exits. This level of detailed accounting is not available in existing literature.

Suggested Citation

  • Tulasiram Nepal & Shishir Shakya, 2025. "Scope-of-Practice Regulations and Physician Assistant Inter-State Practice Relocation," Journal of Labor Research, Springer, vol. 46(1), pages 32-51, June.
  • Handle: RePEc:spr:jlabre:v:46:y:2025:i:1:d:10.1007_s12122-025-09371-6
    DOI: 10.1007/s12122-025-09371-6
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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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