Vol. 24 Annals of Health Law 290
states.29 Given that the Duke PA Program generated rapid interest in the
new profession and served as the impetus for other medical institutions to
start similar programs, the need for a framework for licensure and regulation was both evident and imperative.30 Recognizing the urgency for uniform professional standards, the federal government awarded a contract to
the Duke Department of Community Health Sciences for a project to design
model legislation for the regulation of PAs in 1969.31 Subsequently, several
conferences ensued on the licensure and regulation of new medical professions, including PAs.32 There was representation from all groups considered
to have substantial interaction with these new healthcare professionals.33
The primary goal was to craft model legislation to advance the posture of
the profession.34 This goal was guided by two core concepts.35 First, since
the PA role was nebulous and the concept still evolving, the legislation
should exemplify patient safety and promote maximum role flexibility.36
Second, because physicians are accountable for the care rendered by a PA,
the physician should ultimately decide the PA’s scope of practice.37
By 1971, the North Carolina General Assembly enacted a law authorizing PA practice.38 The new law, embodied within Section 90-18 of the
North Carolina General Statutes, amended the medical practice act and provided an exception for assistants to physicians.39 According to the amendment, assistants who were both approved by and registered with the North
Carolina Board of Medical Examiners were permitted to perform acts, tasks
29. DUKEUNIV.,DEP’T. OFCMTY. HEALTHSCI.,DUKEPHYSICIAN’SASSOCIATE
PROGRAM: LEGAL STATUS AND INSURANCE [INFORMATIONAL PAMPHLET SERIES] 3 (1966-
1972) available at https://medspace.mc.duke.edu/sites/default/files/dumca_4891_PA-0132-
03.jpg (regarding the legal framework and AG opinion).
30. See E. Harvey Estes, Jr. & Reginald D. Carter, Accommodating a New Medical Profession: The History of Physician Assistant Regulatory Legislation in North Carolina, 66
N. C. MED. J. 103, 104 (2005); Reginald D. Carter & Henry B. Perry, Alternatives in Health
Care Delivery: Emerging Roles for Physician Assistants, in PHYSICIAN ASSISTANT: A GUIDE
TO CLINICAL PRACTICE 78, 82 (Ruth Ballweg et al. eds., 5th ed. 2013).
31. Estes, Jr. & Carter, supra note 30, at 104.
32. See id. at 104-05 (“The first conference was held in Durham, North Carolina, on
October 26 and 27, 1969” and the “second conference was held in Durham, North Carolina
on March 1, 1970”).
33. Id. at 104. Participants included nationally recognized experts on the licensure of
health personnel, representatives from medicine and hospital administration in the state,
members of the North Carolina legislature, educational representatives from Duke University School of Medicine and the PA Program, members of the newly graduated classes of PAs
and their employing physicians, among numerous others.
34. Carter & Strand, supra note 27, at 250.
38. See 1971 N. C. Sess. Laws 1193 (providing an exception to the medical practice act
relating to assistants to physicians).
39. N. C. GEN. STAT. ANN. § 90-18(14) (WEST 1971).