Vol. 24 Annals of Health Law 298
19,000 persons.110 As of 2014, 190 accredited PA programs exist in the
United States111 and an additional seventy-five programs have applied for
accreditation evaluation as reported by the Accreditation Review Commission on Education for Physician Assistants (“ARC-PA”).112 U.S. PA programs are intended to be educationally efficient by confining the curriculum
to two to three years and continuing the education process year-round.113
B. Determinant 2: Physician Delegation
A major defining characteristic of PA scope of practice is physician del-
egation.114 Unlike some health personnel who have unique skills, such as
physical therapists and occupational therapists, the PA has a general skill
set similar to that of a physician.115 PAs perform acts of medical diagnosis
and treatment that comprise the legal definition of medical practice.116 The
scope of services that PAs are trained to perform is broad, ranging from
routine examinations and diagnostic maneuvers to prescribing medications,
performing minor surgical procedures, and assisting at surgery.117 In order
for PAs to apply their skills in clinical practice, states require that PAs practice with a physician or group of physicians and are delegated specific
However, for physicians with unlimited licenses to perform all medical
functions, the critical questions become what medical functions they may
110. Glicken & Miller, supra note 103, at 1884.
111. Accredited Programs: Program Data, ACCREDITATION REV. COMM’N ON EDUC.
FOR THE PHYSICIAN ASSISTANT, http://www.arc-pa.com/acc_programs/program_data.html
(last visited Nov. 21, 2014).
112. Notice of Actions – Accreditation Status, ACCREDITATION REV. COMM’N ON EDUC
FOR THE PHYSICIAN ASSISTANT (Oct. 27, 2014), http://www.arc-pa.com/documents
113. See generally PHYSICIAN ASSISTANT EDUC. ASS’N, TWENTY-SEVENTH ANNUAL
REPORT supra note 106, at 10 (inferring efficiency from the length of the curriculum; the
weeks spent in each phase and the vacation time included in the program length indicate it is
a year-round program with vacation time dispersed throughout).
114. See Jane C. Record et al., New Health Professions After a Decade and a Half:
Delegation, Productivity and Costs in Primary Care, 5 J. POL. POL’Y & L., no. 3, at 470,
472-80 (1980) [hereinafter New Health Professions].
115. Roderick S. Hooker, Medical Care Utilization: MDPA/NP Comparisons in an
HMO, in PHYSICIAN ASSISTANTS: PRESENT AND FUTURE MODELS OF UTILIZATION 68 (S. F.
Zarbock & K. Harbert eds., 1986). See also Richard E. Johnson & Donald K. Freeborn,
Comparing HMO Physicians’ Attitudes Towards NPs and PAs, 11 NURSE PRACT. 39-52
(1986). See also Richard E. Johnson et al., Delegation of Office Visits in Primary Care to
PAs and NPs: The Physicians’ View, 10 PHYSICIAN ASSISTANT, no. 1, 159-169 (1985).
116. Hooker, supra note 115, at 68-73; See also MD. CODE ANN., Health Occupations §
14-101(o) “‘Practice medicine’ means to engage, with or without compensation, in medical:
(i) Diagnosis; (ii) Healing; (iii) Treatment; or (iv) Surgery.”
118. New Health Professions, supra note 114, at 472.