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Many experts see PAs as important contributors to emerging strategies to deliver health care more efficiently and effectively, but important barriers exist that could slow the growth of the profession. For example, state laws and regulations may not be broad enough to encompass the professional competencies of PAs. In addition, state statutes and regulations impose widely diverse restrictions on physicians’ ability to delegate authority to PAs, which, in some instances, are overly strict. However, limited research exists that evaluates the quality of care that PAs provide under different supervisory and scope-of-practice arrangements to support reducing such restrictions. In addition, PA training programs face the same shortage of clinical training locations that most clinically based professional programs are experiencing. Finally, limited data indicate that PAs, like physicians, respond to economic incentives by shifting away from primary care and underserved communities in favor of higherpaying specialty care.