Studies were undertaken to assess the practice prerogatives of nonphysician
clinicians (NPCs) in 10 disciplines that, collectively, are the major nonphysician
contributors to the delivery of medical and surgical services. These disciplines
include nurse practitioners, physician assistants, nurse-midwives, chiropractors,
acupuncturists, naturopaths, optometrists, podiatrists, nurse anesthetists,
and clinical nurse specialists. Marked differences were found in the practice
prerogatives that states granted NPCs in the various disciplines. For most
disciplines, the magnitude of their prerogatives correlated with the numbers
of NPCs practicing in each state. At their maximal levels, state practice
prerogatives authorized a high degree of autonomy and a broad range of authority
to provide discrete levels of uncomplicated primary and specialty care. The
recent growth in these prerogatives is fostering new opportunities for NPCs;
however, it also is creating a pluralism that has the potential to further
fragment the US health care system. It is time for regulatory integration
and professional collaboration so that a health care workforce that includes
a diversity of disciplines can be assured of providing a coherent set of patient
care services in the future.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 101
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.