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Home State legislation prevents some PAs from serving their communities during COVID-19

State legislation prevents some PAs from serving their communities during COVID-19

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Thousands of Americans are currently hospitalized as a result of COVID-19 and that number will continue to increase in the coming weeks and months. While there are signs the curve is flattening in hot spots like New York and New Jersey, the novel coronavirus pandemic is placing an incredible strain on America’s healthcare system.

In an effort to prevent physician burnout and better manage the crisis, politicians like Illinois Governor, JB Pritzker and New York City Mayor, Bill DeBlasio are asking retired physicians and nurses to return to work. Healthcare workers from states that are not seeing as serious effects are also heeding the call, volunteering their time and expertise to travel to the front lines.  

These efforts are encouraging, but one group of professionals that’s being overlooked in the rush to contain the virus is physician assistants. Before the outbreak, only 13 states allowed physician assistants to practice without a supervisory or collaborative agreement with a medical doctor. Over the course of the last few weeks, three other states––New York, Tennessee, and Maine––have joined their ranks, thanks to executive orders issued by governors. That still leaves most states––34 in total––that prevent physician assistants from practicing without supervisory restrictions. As case numbers continue to rise and hospitalizations increase, many experts argue there’s no time to lose debating the implications of such an important decision. 

Many professional medical organizations, including the American Academy of Physician Assistants (AAPA), believe the title of physician assistant is a misnomer. When the profession was first established during the 1960s, there was a shortage of medical doctors, and physician assistants did serve as assistants. However, in the years since, the role of physician assistants has changed drastically.  

Physician assistants play a critical—and sometimes primary—role in patient care. They write prescriptions, make diagnoses, manage treatment plans, and in many cases, serve as an individual’s primary healthcare provider. In states where physician assistant restrictions have already been lifted, these men and women are on the frontlines of the pandemic, working with patient’s one on one.

The AAPA argues that the best way to ease the stress on America’s hospitals, emergency rooms, and clinics would be to lift the restrictions caused by supervisory and collaborative agreements. The traditional way to do this is with the help of state legislators. Because of social distancing measures, many states have placed a hold on government activities, including the proposal and passage of new legislation.

Some states hope to reopen businesses and government functions soon, but it may take until summer for others. The only other way to provide physician assistants with the freedom they need is through executive orders signed by state governors.

The U.S. Departments of Health and Human Services made the recommendation in 2017 as part of their report titled: Reforming America’s Healthcare System Through Choice and Competition. Specifically, the report stated that “health care markets could work more efficiently, and Americans could receive more effective, high-value care if we remove and revise certain federal and state regulations and policies that inhibit choice and competition.”

Physician assistants are highly qualified medical professionals that undergo years of school and hands-on clinical experience. They have the knowhow and ability to play lifesaving roles in the health crisis America is currently facing.  

Since physician assistants in a handful of states are already answering the call, the AAPA argues that physician assistants all over the country––no matter their location––should be able to as well. Until governors take action, though, thousands of men and women who are capable and qualified will have to wait.  

In just the last few days, several states have made exceptions to current laws in order to free up medical resources and encourage better collaboration. These include expedited licensure processes, implementing nontraditional practice agreements, accelerating billing privileges, and waiving background check requirements. You can access a complete list of these changes here. The AAPA is also keeping a list of suspended and waived practice requirements that you can access here.  

Here at DocCafe, we’re monitoring these changes closely. Check back in the coming weeks for updates.

State legislation prevents some PAs from serving their communities during COVID-19
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.


Mary Housley
Mary Housley says:
May 21, 2020 AT 11:49 AM
Why were Nurse Practitioners left out of this report? NP’s also began in the 1960’s when the physician shortage was a problem. This requires a 4 year degree in nursing with years of clinical experience and a master’s degree in Science or Nursing plus another year of clinical residencies in the specialty of choice. Many NP’s work as providers in areas such as critical care managing acutely ill patients. The Nurse Midwife specialty began in the 1800’s when midwives wanted more education. They are primary providers, cardiology, neurology gerontology specialists and more. In many states legislative changes has allowed NP’s to open their own practice without oversight of physicians. Perhaps the Physician Assistant gets more “rank” because they used the word physician as part of their title whereas the perception of the Nurse Practitioner title still suggests that the nurse role is that of being subservient to the physician! Therefore the nurses and Nurse Practitioners are here really thought of as females and the Physician Assistants are generally males. This article is offensive not recognizing the NP who is more educated from a nursing perspective and the physician assistant approaches the medical model. They are taught to be first assist in the operating room but in general it can be a Nurse Anesthetist that is doing the anesthesia for the surgery! Thank you for reading this and the opportunity to respond to the article. Note to the author I hope