Vol. 24 Annals of Health Law 296
The United States regulates an extensive array of health professions and
health occupations.92 The enactment of state laws governing the licensure of
PAs and other non-physicians has traditionally been amiable with the primary intent of protecting licensees and patients.93 This is in sharp contrast
to medical licensure laws enacted to remedy known misuse of self-sufficient practice.94
III. DETERMINANTS OF PA SCOPE—ABILITY VS. AUTHORITY
Scope of practice is a term used to describe the types of services a
healthcare practitioner can provide.95 It is important to recognize the difference between professional scope of practice and legal scope of practice.96
Professional scope of practice is a profession’s description of the services
its members are trained and competent to perform.97 Legal scope of practice
is a term often used by states and other jurisdictions to define the activities
of a licensed health professional.98 Each jurisdiction has laws, licensing
bodies, and in most cases, regulations that describe requirements for education and training, and legal scope of practice.99 Within a state, a narrower
governing body such as a hospital or clinic may refine the scope of practice
for the individual practitioner, further limiting the licensee’s scope to a specific range of services or specific procedures.100 PA scope of practice is
generally defined by four determinants: PA education, experience, and
preference; physician delegation; facility credentialing and privileging; and
state law and regulation.101
Sp. ‘ A’ 23rd Leg. Sess.). See also KY. REV. STAT. ANN. § 311.856(2) (West, WestlawNext
through 2014 legislation).
92. See HOOKER ET AL., supra note 89, at 408 (2010) (asserting that there are more than
thirty-six regulated health professions in the United States and more than 200 health vocations).
93. Id, at 409 (asserting that these statutes have usually been “friendly” regulations enacted with the cooperation of the professions and occupations and designed to protect both
the regulated personnel and the public from unqualified and unethical practitioners).
94. See id. at 409 (stating that unlike medical licensure laws, state licensure statutes for
PAs, allied and auxiliary health personnel, and nurses were not enacted to correct abuses of
independent entrepreneurial practice).
95. Catherine Dower et al., It Is Time To Restructure Health Professions Scope-Of-Practice Regulations To Remove Barriers To Care, 32 HEALTH AFF. 1971, 1972 (2013).
100. HOOKER ET AL., supra note 89, at 276.
101. Id. at 418. See also AM. ACAD. OF PHYSICIAN ASSISTANTS, STATE LAWS FOR
PHYSICIAN ASSISTANTS 4 (14th ed. 2014) [hereinafter STATE LAWS 14TH ED.]. See also RUTH
BALLWEG ET AL., PHYSICIAN ASSISTAN T: A GUIDE TO CLINICAL PRACTICE 741 (5th ed. 2013).