West Virginia Law Review

Document Type

Student Note


The shortage of health care professionals in West Virginia today is a matter of grave concern, especially to inhabitants of rural areas where professional medical care is often nonexistent. Statistics are indicative of the problem, but do not reveal the entire picture. For example, in the United States today, there are approximately 171 physicians per 100,000 population. In West Virginia, each 100,000 persons is served by only 111 physicians. This figure alone is cause enough for concern, but the seriousness of the situation is more accurately indicated by the distribution of the physician population. West Virginia is primarily a rural state with a few large urban centers. Fully two-thirds of West Virginia's licensed physicians reside in twelve counties. In contrast, Putnam County has a population of 27,625 and only three physicians; Tucker County has one physician for its 7447 residents. The hospital bed situation is of similar gravity. In Monongalia County, for example, there are a mere ninety-nine persons per hospital bed. The figure is 162 per bed in Kanawha County-still highly acceptable. However, Boone County, with a population of over 25,000, has one hospital bed for each 598 persons-more than a little crowded. It is difficult to arrive at any definite conclusion as to the reasons for the health manpower shortage in West Virginia. Economic reasons are perhaps the most obvious. Practice in many of West Virginia's rural counties may not be especially lucrative relative to that in large metropolitan areas. Additionally, licensure laws, such as the citizenship requirement for foreign physicians, may deprive West Virginians of readily available health care? Furthermore, the licensure laws, with their strict penal sanctions, may constrain innovative procedures. In recent years, West Virginia, along with a number of other states, has taken steps to alleviate the shortage of health care personnel. Potentially the most significant of these is the statutory legitimation of the "physician's assistant," a highly trained, skilled individual who is equipped to provide primary health care under the supervision of a licensed physician. This article will examine the PA concept, the nature of the West Virginia PA law, and problems of liability facing the PA and his supervising physician.



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