By NextBestFitScope-of-practice limits waste capacity
Nurse practitioners (323,000), physician assistants (162,000), pharmacists, and dental therapists are trained to do more than many states allow.
Evidence
- 323,040 nurse practitioners and 162,150 physician assistants (BLS).Sources: Bureau of Labor Statistics (2026)
Who's affected
Who is hurt
- Residents of areas with too few health professionals: Practice limits prevent trained professionals from filling care gaps.
Who gains while it lasts
- Doctors, nurses, and other clinicians: Physicians benefit from a protected market.
Under your mix of paths
Paths that fix or soften it
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Root causes
- State licensing rules shaped by professional lobbying
Related costs
Open questions
- Which professionals should be allowed to do what, independently?
Solution paths (2)
Open a path for what it fixes, what it creates or worsens, who gains and who loses, precedents, and how it connects to other paths. See all paths as a decision tree.
Let each profession practice to the full extent of its training.
- +Scope-of-practice limits waste capacity
- +Physician shortage, especially in primary care
- +Health professional shortage areas
- +Longer waits if demand grows faster than capacity
- −Quality concerns when non-physicians practice independently
Expand roles within teams under physician supervision.
- +Scope-of-practice limits waste capacity
- +Longer waits if demand grows faster than capacity
- −Raises spending or loosens control over it
- −Solves only part of the problem