Do PA licensure questions violate the Americans with Disabilities Act?

Objective: Negative stigma related to mental health diagnoses is common in both clinicians and the public. Questions about physical and mental conditions on licensure applications often are overly broad and may violate the Americans with Disabilities Act (ADA). This study investigated state physician assistant (PA) licensing applications relating to physical and mental health, and their consistency with the ADA.

Methods: We collected PA state licensure applications from all 50 states and the District of Columbia. To be considered consistent with the ADA about physical conditions, an application had to only contain questions about a current (within the past year) physical health condition that impaired the applicant's ability to practice as a PA, or not include any questions about physical health. Questions that asked for speculation about possible future situations were considered inconsistent with the ADA.

Results: Nearly 57% of state PA licensing applications were consistent with ADA guidelines on physical conditions; 51% were consistent for mental health conditions.

Conclusions: Many state PA licensing boards include questions about physical and mental health conditions that are not limited to current impairment. These licensure questions could violate the ADA, and may reduce PAs' willingness to seek help for mental health issues. Balancing public safety with clinician health is a challenge. Further research and action are needed to optimize PA licensure questions on physical and mental health.