The American Medical Association says it supports the National Governors Association's recommendations, which "closely align with AMA's policy supporting healthcare teams that draw on telemedicine and the unique strengths of physicians and physician assistants."
The National Governors Association says states should review and consider easing scope-of-practice restrictions on physician assistants so they can help with growing patient workloads anticipated under healthcare reform and the Medicaid expansion.
"PAs are an important component of developing strategies to deliver healthcare more efficiently and effectively," Washington Gov. Jay Inslee (D) said in prepared remarks accompanying the release of The Role of Physician Assistants in Health Care Delivery.
"Finding ways to eliminate the regulatory barriers that exist for PAs is crucial to growing the profession," he said.
The report identifies barriers that prevent PAs from practicing at the top of their license, and offers suggestions for state policy leaders who are trying to maximize the efficiencies of their PA workforce.
For starters, the NGA report says states should review their existing laws and regulatory framework for PAs to ensure they aren't antiquated, unduly narrow, or overly burdensome on the profession, and that they're not restricting the future supply of PAs.
In addition, the report recommends that all states grant PAs legal standing to provide care under laws governing medical practice. The report also recommends that states create greater educational opportunities for PAs.
"Our state has an effective program, and one that educates returning veterans, typically medics, to become PAs to fill important primary care jobs," Inslee said. Physician associations have offered guarded and conditional support for PAs as members of a care team led by physicians.
"The American Medical Association commends the National Governors Association for its examination of the role of physician assistants in health care delivery," said Robert M. Wah, MD, president of the American Medical Association, in a media statement.
"The NGA's recommendations closely align with AMA's policy supporting healthcare teams that draw on telemedicine and the unique strengths of physicians and physician assistants to ensure access to coordinated, patient-centered quality care."
American Academy of Physician Assistants President John McGinnity, MS, PA-C, reached last week, says he is delighted by the report, and not surprised by its recommendations.
"We've been saying this for two or three years now, that folks are recognizing the role that PAs can play in healthcare. Now it is exciting to see everybody starting to believe in things we've been doing for many years," McGinnity says.
"For a long time I've been saying we are the best-trained most flexible profession to handle our nation's healthcare needs. When you look at the average PA who's been in practice for more than 10 years, they've changed specialties at least twice. That's a unique flexibility that PAs offer the healthcare team, the flexibility to go where marketplace needs are."
McGinnity says the number PAs has more than doubled each decade since the profession was created in 1967. "We have over 100,000 practicing PAs. We have 191 programs in the nation and we are graduating more than 6,000 PAs each year. I see barriers falling left and right," he says.
"The problem is that when these laws were written, PAs really weren't around. The states need to go back and update antiquated laws to say 'OK, how can we have all clinicians, no matter who they are, practicing as a team?' That is really the key. We've been doing team before team was cool. We wanted to partner with everyone in healthcare just to improve patient outcomes."
McGinnity argues that regulations for PAs should "equate" to regulations for physicians.
"They should treat PAs as they do physicians," he says. "We practice medicine. We're trained in the medical model and we need to remove those barriers to improve access for patients. This is truly about the patient."
While scope-of-practice skirmishes continue with physicians, McGinnity believes there is also a growing mutual respect in both camps and a sense that they need each other. "You've now got states where the medical society and the PA groups are saying 'Hey listen. Medicine is a team sport,'" he says.
"Do we all agree 100% of the time? No! Are we working together to try to come up with solutions? Absolutely!"
John Commins is the news editor for HealthLeaders.