State legislatures increasingly are lifting regulatory roadblocks for physician assistants (PA), partly in hopes of alleviating the United States' doctor shortage, writes Bruce Japsen for Forbes.
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According to Japsen, the number of PAs has increased in recent decades from 20,000 in 1990 to more than 115,000 today.
"Placements of advanced practice clinicians, primarily PAs, have grown steadily since 2012," said Andrea Clement, the spokesperson for The Medicus Firm, a national health care staffing firm. "In 2016, non-physician, advanced practice placements comprised 12 percent of total provider placements, up from 8.3 percent in 2015. Physician assistants were the 2nd most frequently placed provider in 2016."
States remove regulatory barriers
This growth, coupled with patients' willingness to be treated by non-physician health care professionals, has prompted many states to ease regulatory limits on PAs that had previously impeded their ability to care for patients.
For instance, Florida and Maine in 2016 passed legislation giving PAs full prescribing authority. Legislatures in New Jersey and South Dakota passed legislation that removing requirements that supervising physicians provide on-site oversight or co-signatures for PAs. New Jersey's legislation went a step further by allowing individual practices to set the scope of practice for PAs.
According to Japsen, the trend appears to be continuing in 2017. Illinois Gov. Bruce Rauner (R) last month signed into law a 10-year extension of its PA Practice Act, which replaces all references to "supervising physicians" to "collaborating physicians," reflecting the closer relationship between PAs and physicians.
Nestor Ramirez, president of the Illinois State Medical Society, praised the change, saying, "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."
Jenna Dorn, the CEO of the American Academy of PAs, said, "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" (Japsen, Forbes, 9/8; American Academy of PAs release, accessed 9/11).
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Prior authorization (PA) processes have long been an administrative burden for providers. In recent years, securing PAs has become even more difficult due to increasing requirements and greater variation in health plan benefit structure.
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