Abstract
ABSTRACT Purpose: Authorizing physician assistants/associates (PAs) to provide care to patients and removing restrictive laws and regulations without sacrificing patient safety is essential to meet the needs of patients and the US healthcare system. The aim of this observational study was to determine if states with permissive compared to restrictive PA scope of practice laws and regulations had higher instances of medical malpractice payment reports (MMPR), a proxy of patient harm. Design: This observational study examined 10 years (2010-2019) of medical malpractice payment reports data from the National Practitioner Data Bank (NPDB) compared to the laws and regulations of states for the same period. Results: Negative binomial regressions indicated no statistically significant differences in MMPR rates between states with permissive versus restrictive PA practice laws and regulations. Five of six practice reforms decreased or had no significant effect on PA and physician MMPR occurrences. One reform was associated with a weak but statistically significant increased risk of MMPRs for PAs and a trend toward a decreased risk for physicians. Conclusion: This study suggests that removing restrictive laws and regulations to PA practice does not increase overall risks to patients or increase rates of malpractice within US healthcare.
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