The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care

Timmons, Edward

doi:10.1016/j.healthpol.2016.12.002

Cited by 63 publications

(44 citation statements)

References 15 publications

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“…In general, NPs and PAs can be substitutes or complements for physicians, and whether NPs and PAs are substitutes or complements for physicians is an open question in the literature . Most of the existing evidence suggests that both professions are complements to physicians, as the (disfavored) term “physician extender,” which is sometimes applied to NPs and PAs, implies (see Stange ; Timmons ). Based on this evidence, I expect that an increase in physician supply will be associated with an increase in NP and PA supply.…”

Section: Institutional Framework and Expected Effectsmentioning

confidence: 99%

Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

McMichael¹

2018

J Empirical Legal Studies

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The increased use of nurse practitioners (NPs) and physician assistants (PAs) represents an important option for increasing access to healthcare. I explore the effect of two types of laws on the supply of NPs and PAs: occupational licensing laws that limit the practices of NPs and PAs and caps on noneconomic damages. Relaxing licensing laws to allow NPs to practice with less physician oversight increases the supply of NPs in areas with few practicing physicians by 60 percent—though the size of this increase decreases as the supply of physicians grows. I find similar, but weaker, evidence for granting PAs more autonomy. Noneconomic damages caps increase the supply of both NPs and PAs by about 60 percent at the lowest levels of physician supply. Examining the effects of these laws on the prevalence of health professional shortage areas, I find that licensing laws have meaningful effects on access to care.

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Section: Institutional Framework and Expected Effectsmentioning

confidence: 99%

Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

McMichael¹

2018

J Empirical Legal Studies

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“…This can represent a quandary in the Age of NCDs. For example, medical institutions oppose pharmacists and nurse practitioners when they lobby for basic expansions in scope of practice-such as the ability to administer vaccines and prescribe various medications [40][41][42].…”

Section: Societal Trust Medical Competenciesmentioning

confidence: 99%

From Authoritarianism to Advocacy: Lifestyle-Driven, Socially-Transmitted Conditions Require a Transformation in Medical Training and Practice

Prescott

Logan²

2018

Challenges

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The epidemic of socially-rooted, lifestyle-driven non-communicable diseases (NCDs; also referred to as socially-transmitted conditions) has now overtaken infectious diseases as the leading cause of human mortality. Despite this reality, physician education, training and practice within industrialized nations is heavily slanted toward the biopharmaceutical (and away from the psychosocial) aspects of prevention and treatment. As we underscore, the current state of physician training and practical application of guidelines pertaining to lifestyle is paltry and untenable. However, the solution is not a few more hours of nutritional biochemistry to check off the curricula box. Physician readiness for the current NCD crisis will require a philosophical shift in medicine-at-large, including candidate pooling. Recent elections in the United States and Europe have cast a spotlight on the public health consequences of political authoritarianism. However, we highlight that authoritarianism-and its related facets of social dominance orientation and Machiavellianism-are not exclusive to political candidates. Here, we open a dialogue on authoritarianism in westernized medicine as a starting point in order to encourage the development of critical research and to explore its potential as a barrier to patient care. We suggest that authoritarianism and its prejudices act as a border wall to the World Health Organization's broad vision of global health, cultural competency and patient autonomy. Moreover, the evidence reviewed here would suggest that in the context of the NCDs crisis, westernized medicine is long overdue a Flexner Report for the 21st Century.

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“…In general, NPs and PAs can be substitutes or complements for physicians, 12 and whether NPs and PAs are substitutes or complements for physicians is an open question in the literature. 13 Most of the existing evidence suggests that both professions are complements to physicians, as the (disfavored) term "physician extender," which is sometimes applied to NPs and PAs, implies (see Stange 2014;Timmons 2017). Based on this evidence, I expect that an increase in physician supply will be associated with an increase in NP and PA supply.…”

Section: Institutional Framework and Expected Effectsmentioning

confidence: 99%

Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

McMichael

2018

SSRN Journal

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The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care

Cited by 63 publications

References 15 publications

Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

From Authoritarianism to Advocacy: Lifestyle-Driven, Socially-Transmitted Conditions Require a Transformation in Medical Training and Practice

Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants

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