An increasing number of states are granting physician assistants more autonomy to increase access to patients amid a shortage of doctors and an influx of patients with health insurance under the Affordable Care Act.
In some cases, states are removing bureaucratic barriers that in the past led to redundant tasks or slowed the ability of patients to get the care they needed. In New Jersey, for example, Gov. Chris Christie in January signed into law legislation that removed the so-called “countersignature requirement,” which previously required the PAs' collaborating physician to countersign all medical orders.
PA Javier Esquivel-Acosta is associate medical director of a federally qualified health center... [+]
New Jersey became the 29th state to get rid of the countersignature requirement as states across the country lift hurdles and allow PAs and nurse practitioners more direct access to patients, particularly when it comes to primary care. The New Jersey legislation also removed a rule that required the PA to have a “continuing or intermittent presence” with a collaborating physician while working in a hospital or other inpatient setting.
“During the past few years we have seen a huge surge in PA positive legislation as states recognize the vital role PAs are playing in helping secure America’s healthcare future,” said Jeffrey Katz, president of the American Academy of Physician Assistants (AAPA). “Just last year, 49 states and the District of Columbia made 201 PA-positive changes to their laws and regulations that have allowed PAs the ability to better serve their patients.”
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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.
PAs work in doctor’s offices, retail clinics and other locations and their work includes diagnosing illnesses, writing prescriptions and counseling patients on preventive care.
In another area of increased autonomy, PAs are being granted “full prescriptive authority,” which will allow them to write prescriptions for controlled substances. Legislation is wending its way through the Florida legislature that would make the state the 49th to have the ability to write such prescriptions.
Physician assistants are increasingly an integral part of value-based care models proliferating across the country like accountable care organizations (ACOs) and patient-centered medical homes that contract with insurers, Medicare and Medicaid programs. Major insurers like
And physician assistants and nurse practitioners are taking on a greater role in treating Americans covered under the health law's expanded Medicaid program, according to the Kaiser Family Foundation. Already, an estimated two-thirds of nurse practitioners and PAs accept Medicaid patients.
