Which state was the first to allow PAs to work without a supervising physician?

• A. California
• B. New York
• C. Utah
• D. Texas

Answer: (C)

PAs gained autonomy as states experimented with supervision rules, and this question hinges on which state first allowed independent practice for PAs. Utah led the way by enacting a PA statute that permitted PAs to work without a supervising physician in certain settings, establishing an independent practice framework earlier than other states. This milestone helped improve access to care, especially in rural areas, and set a model that influenced later regulations in other states. California, New York, and Texas eventually broadened PA practice too, but Utah’s act is recognized as the earliest move toward independent PA practice.