Much of the variation between states makes more sense once you know what it is variation toward.
The policy position
Optimal Team Practice is the professional argument that PA practice should be governed by the practice itself rather than by a legally mandated relationship with a specific physician — eliminating the requirement for an agreement as a condition of licensure, with accountability sitting at the practice level.
What it has actually produced
Not wholesale adoption. Incremental change, unevenly distributed: supervision language replaced with collaboration language; on-site presence requirements relaxed to availability; hours-based tiers where experienced PAs graduate from supervision; ratio caps raised or removed.
Which is why states cluster at different points on the same path rather than falling into two camps.
Why it matters for a license application
It explains why the collaboration requirement is the part of an application that varies most, and why experience can change what a state asks of you. A PA with several thousand documented post-graduate hours may face materially lighter requirements than a new graduate in the same state — which is only useful if you have the documentation to prove the hours.
The practical implication
Keep a record of post-graduate practice hours by specialty as you accumulate them. Reconstructing them later from employment records is unpleasant, and in states with hours-based tiers it is the difference between two regimes.
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