Kathryn Kugler: To attract more physician assistants, Pa. needs modernized laws
Pennsylvania educates more PA (physician assistant) students than almost any other state. With one of the highest numbers of accredited PA programs in the country — 23, to be exact — our state has access to an enormous group of bright, ambitious, well-trained medical providers who can help to improve Pennsylvania’s health care system.
PAs are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal health care provider. With thousands of hours of medical training, PAs practice in every medical setting and specialty.
It’s a no-brainer: We should be doing everything we can to keep newly graduated PAs in the state to care for our patients. But, unfortunately, that isn’t the case. Current laws in Pennsylvania make it less appealing for these PAs to remain and practice here, so we’re losing them to nearby states.
Health care is a team sport and on health care teams, PAs work closely with physicians. Under current Pennsylvania laws and regulations, there is a large paperwork burden on physician-PA teams. An individual PA’s scope of practice, or what he or she will handle in day-to-day-practice in coordination with other members of the health care team, is determined and approved by the medical and osteopathic boards.
This means that physicians and PAs don’t have the final say in deciding how they’ll work together. Instead, it’s decided for them, even though the PAs and physicians on the ground have a better grasp of what will work best at their specific practice.
This approval process has created a severe backlog of scope-of-practice applications, which leaves physician-PA teams facing a 120-day delay for their application’s approval. This not only places a financial burden on practices and hospitals hoping to employ PAs, but also places a burden on PAs themselves.
In my practice, for example, one of the physicians on our team left to pursue other opportunities. We had all worked together as a team for two years, and the departing physician was the primary supervisor for one of my PA teammates. Due to Pennsylvania’s outdated laws, paperwork was submitted to change her supervising physician as required. Her job responsibilities were remaining the same, and all of the other physicians on our team were still there.
In the middle of a fully scheduled day of patients, we discovered that the removal of the physician leaving our practice had been processed, but the assignment of the PA’s new supervisor had not. This meant that she had to stop seeing patients immediately, leaving patients in exam rooms unable to see the PA they were scheduled with that day. This took numerous phone calls and many days to resolve, so patients were left without care.
All of this bureaucratic red tape has led to “brain drain.” New PAs, having just graduated from a program in Pennsylvania, choose to cross state lines and practice elsewhere in a state that makes it easier for them to get licensed and start practicing. As a result, patients in Pennsylvania lose out.
As the population grows and the number of senior patients increases, we need as many qualified medical providers in the state as we can get. Time and time again, PAs have been proven to provide high-quality medical care and as medical generalists, PAs can provide a wide spectrum of patient care and treat the “whole patient.”
This important legislation will modernize PA practice in the state by removing red tape, along with a few other crucial changes. It aims to give PAs and physicians more flexibility to decide how they want to work together, rather than follow a rulebook written by regulators uninvolved in their daily practice.
There are two significant benefits to this change: First, it helps to ensure that patients have the best possible care, customized to their specific needs. Their healthcare team, including physicians and PAs, can work together on the patient’s treatment without restrictions on how they arrange that care.
Second, this change makes it easier for employers like hospitals and health systems to employ PAs – meaning more of them will be attracted to practicing in Pennsylvania.
PA students enrolled in a PA program in Pennsylvania have already chosen our great state once. Let’s do everything we can to make sure that once they become PAs, they choose Pennsylvania again.
Kathryn Kugler, PA-C, MEd., is the immediate past president of the Pennsylvania Society of Physician Assistants.