States Lift More Hurdles To Physician Assistants
An unprecedented number of regulatory hurdles are falling for physician assistants seeking more autonomy in their efforts to treat patients.
In some cases, states are easing barriers that in the past led to redundant tasks or slowed the ability of patients to get the care they needed in a timely fashion. Such changes to regulations or scope of practice laws are taking effect this year as the result of state legislative sessions completed this summer.
“In 2016, every state made at least one PA-positive change to their laws or regulations (and) this tidal wave of support is continuing in 2017,” Jenna Dorn CEO of the American Academy of PAs said of the myriad legislative and regulatory changes. “State and federal lawmakers recognize the value of the PA profession and understand that removing outdated PA practice barriers enhances patient access to care.”
Like nurse practitioners and allied health professionals in general, barriers to PAs are falling for a variety of reasons including a doctor shortage and general comfort U.S. patients have with being treated by someone other than a physician.
PAs work in doctor’s offices, clinics, hospitals and other locations and their work includes diagnosing illnesses, writing prescriptions and counseling patients on preventive care. There are now more than 40 states that have implemented “full prescriptive authority” for PAs with the addition in the last year of Maine and Florida.
In many cases, state rules date back to a time when there were few PAs and patients got their care mostly from a physician. Today there are more than 115,000 PAs compared to 20,000 in 1990.
In Illinois, where it took the state two years just to pass a budget, Gov. Bruce Rauner last month signed into law a 10-year extension to 2028 of the state’s PA Practice Act to better reflect the relationship between PAs and physicians. The Illinois regulation “replaces references to ‘supervising physicians’ with references to ‘collaborating physicians’ throughout the Act,” the Illinois General Assembly’s language in the bill says.
“This legislation brings the language of the Physician Assistant Practice Act in line with that of other licensure acts,” said Dr. Nestor Ramirez, president of the Illinois State Medical Society, which represents physicians and supported the act. “Patients are best served by physician-led teams of professionals practicing within the scope of their licensure, and physicians work collaboratively with PAs and other allied health care professionals to ensure that the care provided is of the highest quality.”
PAs and lawmakers passing such legislation say they are essentially granting physician assistants the ability to do what they are trained to do. Most have a two-year master’s degree, often from a program that runs about two years and includes three years of healthcare training, according to the AAPA.
Increasingly, PAs are finding themselves more closely integrated with the team-based approach to healthcare delivery as insurers shift payments to providers to value-based models from fee-for-service medicine.
The team-based approach that includes PAs is figuring into decisions by medical educators to have them work more closely with physicians-in-training. Stanford University recently unveiled the first class in a new 30-month Master’s degree program that “emphasizes training for physician assistants alongside medical students for coursework and clinical care.”
The acceptance of PAs has led to an unprecedented demand to hire the profession at hospitals, clinics and other health facilities, recruiters say.
“Placements of advanced practice clinicians, primarily PAs, have grown steadily since 2012,” said Andrea Clement, spokeswoman for The Medicus Firm, a national healthcare staffing firm. “In 2016, non-physician, advanced practice placements comprised 12% of total provider placements, up from 8.3% in 2015. Physician assistants were the second-most frequently placed provider in 2016.”