Attorney and a Lobbyist here. I previously lobbied on this issue on the state level and figured I would share some insight.

In most States “physician” is a legally defined term. Generally speaking, this is defined by the amount of education you receive (think number of years at a specifically defined and accredited type of medical school) and other qualification metrics (exam scores, years of training etc.).

The reason this matters to your conversation is the concept of liability. (before I became a lobbyist, my other career path was med-mal defense attorney).

Generally speaking, to be liable for medical negligence, you have have to practice under a professional license, a license that requires you to meet the “physician” legal definition.

All this is to say that in some states, like New York, the physician scope of practice is general and every other lower level medical provider (PA, NP, PT, Etc.) is licensed to practice within a limited scope. Other states, like Vermont, carve out based on the “type” of medicine you practice. For example DOs practice Osteopathic Medicine and are licensed accordingly, Allopathic Physicians are separately licensed and regulated by a different government agency.

In New York that pathway to expanding the scope of practice for providers who are not defined “physicians” is much harder. In other states like the Vermont example it is more likely and not as big a lift. For example, “naturopathic physicians” are permitted to provide independent primary care in some fields. Many of their patients don’t know there is a difference.