Vol. 24 Annals of Health Law 292
regardless of their qualifications.52
The bulk of state legislatures repudiated statutes that simply amended the
state medical practice act and allowed physician delegation of patient care
tasks within their scope of practice to PAs they supervised.53 This was due
in large part to the fact that such laws allowed physicians to be the single
arbiter of both the PA’s educational criteria and medical duties.54 Consequently, state legislatures enacted more comprehensive laws, endowing a
designated regulatory body—usually the state board of medical examiners—the authority to adopt rules and regulations relevant to PA education
and employment.55 These types of laws diminished the malleability of the
physician-PA teams at the time, but afforded greater patient safety because
the PAs were required to satisfy fixed educational and skill requirements
prior to their receiving consent for employment.56 This also enabled physicians to recognize the qualifications necessary for safe and effective PA
practice.57 The general celerity of the regulatory process led to it being favored for its ability to promptly reflect new information and knowledge
about PAs.58 The regulatory approach had disadvantages, including the ability of regulators to establish differing educational and experience requirements—resulting in a lack of standardization and uniformity across the
country.59 In addition, state medical boards were lacking the capital, and often the proficiency, required to formulate and administer examinations for
applicants or carry out accreditation functions applicable to training curricu-
Irrespective of the form of the legislation, twenty-four states enacted PA
laws by the end of 1972.61 Of these twenty-four, Colorado was the first and
only state to permit limited prescriptive authority to graduates of the University of Colorado’s child health program.62 Eight of these states required
the physician and the PA to submit a job description outlining the PA’s
scope of practice to the board for approval.63 Additional health profession-
53. Id. at 6-7.
55. Id. at 7.
61. Id. at 3.
62. ASPEN HEALTH LAW CTR., PHYSICIAN ASSISTANT LEGAL HANDBOOK 14 (Aspen Publishers 1997).
63. Dean, supra note 42, at 7 (“To further protect patients from incompetence eight
States (Alabama, California, Florida, Georgia, Iowa, Oregon, Washington, and West Virginia), either by legislation or regulation, require that physician and his proposed assistant to