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The Extraregulatory Effect of Nurse Practitioner Scope-of-Practice Laws on Physician Malpractice Rates.

Authors
  • McMichael, Benjamin J1
  • Safriet, Barbara J2
  • Buerhaus, Peter I3
  • 1 1 Vanderbilt University, Nashville, TN, USA.
  • 2 2 Lewis & Clark Law School, Portland, OR, USA.
  • 3 3 Montana State University, Bozeman, MT, USA.
Type
Published Article
Journal
Medical care research and review : MCRR
Publication Date
Jun 01, 2018
Volume
75
Issue
3
Pages
312–326
Identifiers
DOI: 10.1177/1077558716686889
PMID: 29148320
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Patients can hold physicians directly or vicariously liable for the malpractice of nurse practitioners under their supervision. Restrictive scope-of-practice laws governing nurse practitioners can ease patients' legal burdens in establishing physician liability. We analyze the effect of restrictive scope-of-practice laws on the number of malpractice payments made on behalf of physicians between 1999 and 2012. Enacting less restrictive scope-of-practice laws decreases the number of payments made by physicians by as much as 31%, suggesting that restrictive scope-of-practice laws have a salient extraregulatory effect on physician malpractice rates. The effect of enacting less restrictive laws varies depending on the medical malpractice reforms that are in place, with the largest decrease in physician malpractice rates occurring in states that have enacted fewer malpractice reforms. Relaxing scope-of-practice laws could mitigate the adverse extraregulatory effect on physicians identified in this study and could also lead to improvements in access to care.

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