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Home Iowa passes law to expand the role of Physician Assistants

Iowa passes law to expand the role of Physician Assistants

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Physician assistants play a critical role in providing healthcare access to millions of Americans. These hard-working men and women perform many of the same tasks medical physicians do, including diagnosing and preventing illness, developing custom care plans, prescribing medications, and answering patient questions. In many cases, physician assistants also act as a patient’s primary medical contact. This is particularly true in rural areas of the country where fewer physicians serve many patients. 

While physician assistants serve an essential role in the medical practice, they don’t have full practice authority. This means that they’re required by law to work under the guidance of a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). 

The roles of physician assistants: differing viewpoints 

Some experts say this requirement is best for everyone involved. While all physician assistants have at least a master’s degree, they aren’t required to complete four years of medical school or a residency program. 

Other experts argue that the strict educational requirements of PA training are on par with that of physicians and nurse practitioners. Students must complete at least 3,000 hours of direct patient experience working as a paramedic, medical assistant, or athletic trainer, and complete an additional 2,000 hours of clinical rotations. In addition, the guidelines requiring physician assistants to work directly under physicians were first established more than 50 years ago, when physician assistant was a new, untested position. 

AAPA and the Optimal Team Practice

The American Association of Physician Assistants (AAPA) argues these guidelines need a major overhaul. Instead of helping to provide essential access to healthcare, they slow things down, and in some cases, prevent patients from receiving necessary services.

In 2017, the AAPA passed a new policy known as the Optimal Team Practice. Under this action, Physicians, PAs, and other healthcare professionals work in collaboration without the administrative burdens many states currently require.

During the last two years, the AAPA has lobbied states to act and eliminate the relationship requirements between physicians and physician assistants. Additionally, the AAPA hopes to create a separate medical board to regulate PAs and make PAs eligible for direct payment from all public and private insurers.   


Coronavirus pandemic and evolving opinions

So far, there’s significant resistance, but that may be changing due to the coronavirus pandemic. As medical systems all over the country become increasingly strained by the outbreak of COVID-19, a growing number of state legislators and governors are taking action. 


Iowa expands the role and abilities of physician assistants

On March 18, 2020, Iowa governor Kim Reynolds signed SF 2357 into law. The bill expands the role of physician assistants by allowing full prescriptive privileges, as well as certain legal protections provided to other healthcare professionals. SF 2357 also gives PAs full reimbursement by Medicaid. 

“Enabling physician assistants to better serve the health care needs of Iowans will result in better care in a more timely fashion,” said Gov. Reynolds. “As the state continues to combat the spread of COVID-19 and the strains it will place on our health care system, this will be yet another tool in our arsenal.”

It isn’t just the coronavirus, though. For the past few years, legislators and healthcare experts have warned that the state is quickly running short on medical professionals. One study conducted by The Robert Graham Center found that Iowa will need at least 119 new primary care physicians by 2030, due to the state’s aging population and growing rates of insured residents.

Iowa’s new law doesn’t eliminate the required PA-physician relationship, but it does loosen guidelines and update them with current policy. This is especially beneficial for people living in rural areas––a group that accounts for 30 percent of Iowa’s population. People require healthcare, regardless of where they live, and expanding access to various resources matters. 

Updating the abilities of physician assistants doesn’t allow these professionals to do anything they want. On the contrary, it enables them to practice to the full extent of their abilities, using their years of training and expertise. 

Iowa is the latest state to expand the role and abilities of physician assistants, but it won’t be the last. As coronavirus continues to spread and America’s health landscape changes, other parts of the country are following suit, including Michigan and Florida.

Iowa passes law to expand the role of Physician Assistants
Chad Birt

Chad Birt is a freelance B2B and B2C medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.


Valerie Stern
Valerie Stern says:
Apr 22, 2020 AT 2:10 PM
Please note that as a PA-C, we are Physician Assistants, NOT a physician's assistant. This is not a possessive title. This gives the wrong impression as to who we are and what we do. Valerie Stern, DMSc, MPAS, PA-C, Physician Assistant (No "s")
Mrs. Connie Dorfner
Mrs. Connie Dorfner says:
Apr 23, 2020 AT 5:20 AM
Journalist and professional writers are not what they used to be used to be. Maybe it is because they can "do whatever they want" - hahahaha
susan Royster
susan Royster says:
Apr 22, 2020 AT 3:26 PM
Totally agree. I’ve said for years we should be called Physician Associates..
Mrs. Connie Dorfner
Mrs. Connie Dorfner says:
Apr 23, 2020 AT 5:29 AM
Connie Dorfner <dorfnercf@battlers.ab.edu> 6:01 AM (18 minutes ago) to news I rarely have anything to say about the asinine mentality out there about PA's, but this just caught me the wrong way when I read the statement from the article: "Updating the abilities of physician assistants doesn’t allow these professionals to do anything they want. On the contrary, it enables them to practice to the full extent of their abilities, using their years of training and expertise. " Seriously??? This is the kind of statement that undermines the intelligence, education, standards of practice and sense of sound judgement, ethics, and responsibility under which a physician assistant practices medicine. The mentality behind such statements as this one in the article is the same mentality that limits prescribing privileges to mid-levels by re-scheduling medications such as opiates, but allows irresponsible doctors, who created a lot of this opiate epidemic in the first place, to continue to "do whatever they want". Mid-levels were never the problem behind over-prescribing opiates, yet the states re-scheduled as if we were out here "doing whatever" with no moral compass or ethical accountability to our patients who KNEW would become addicted to opiates. My cat would know not to prescribe opiates long-term. No one in the medical community is allowed to "do anything they want", for goodness sake. ALL medical providers are held to the same standards of care - even an MD/DO straight out of medical school with less experience and education than I have as a physician assistant has to practice according to standards of care and medical guidelines. From what source information and research about how PA's practice did this statement in the article come? Anyway, physician assistants are NOT looking to "do whatever we want". We have and always will do what is medically sound based on our education and experience. We aren't a bunch of wild cards out here treating patients however "we want" - we treat based on sound evidence and medical guidelines - just like any other medical provider. Medical guidelines and standards of care keep every medical professional in line - whether their medical title requires a supervising physician or not. Connie Dorfner, MPAS, PA