Conor Norris and Edward Timmons: Physician assistants can help health care shortages, if we let them

Bill before Utah Legislature would allow PAs to practice independently.

(Otto Kitsinger | AP photo) Physician assistant Nicole Thomas conducts a COVID-19 examination in the parking lot at Primary Health Medical Group's clinic in Boise, Idaho, Tuesday, Nov. 24, 2020. The urgent-care clinic revamped into a facility for coronavirus patients as infections and deaths surge in Idaho and nationwide. Some 1,000 people have died due to COVID-19, and infections this week surpassed 100,000.

COVID-19 has shown just how important reforms to health care regulations can be to provide adequate access to care for patients. The Utah Legislature continues to step up, helping Utahans get the health care they need by allowing physician assistants to practice independently.

Since last spring, COVID-19 has caused sudden spikes in demand which threatened to push hospitals over capacity. But these issues of difficulty accessing care existed before COVID-19. In fact, we have been suffering from a shortage of physicians nationally for years.

Utah is not immune. Currently, 15 Utah counties are considered Health Professional Shortage Areas. These tend to be in rural or low-income urban areas.

Even without COVID, this access to health care makes life difficult for too many Utahans. Worse health outcomes are driven by long wait times and patients opting to delay care. But the Utah Legislature has been proactive trying to find a solution to expand access to care without sacrificing quality for patients.

One simple solution to health care provider shortages is using the ones we already have. Utah has the chance to do just that now with Senate Bill 27. This bill would allow Utah to join North Dakota and become just the second in the nation to allow PAs to practice independently. This bill would give PAs the flexibility to serve more patients.

PAs are clinicians that perform many of the same tasks as physicians. They diagnose and treat illnesses, prescribe medication and conduct physical exams. They go through three years of training with 2,000 hours of clinical rotations.

This bill would allow PAs to practice to their full training and ability. Rather than allowing them to perform new tasks and treatments, the legislation merely allows them to practice to the full extent of their training. PAs are highly skilled and competent health care providers. SB27 would treat them like it.

Every role in the health care team is important, and each should provide the level of care that they can perform at a high level. Independent practice for PAs will do just that, while allowing physicians to focus on the type of care only they are able to provide.

Utah won’t be turning PAs loose. They will still be required to be supervised by a physician for their first 4,000 hours of practicing after graduation. And for the following 6,000 hours, they will need to be supervised by a physician or another experienced PA.

While Utah would be the second state to allow independent practice, it has growing momentum.

But not everyone is totally on board. The state medical association is skeptical. They cite concerns that independent practice could threaten patient safety, because PAs do not undergo the same level of education and training as physicians.

The law does not change how PAs practice, however. Rather than adding procedures for PAs to perform, it allows experienced ones to practice without an agreement with a physician. PAs already treat patients without a physician standing over their shoulder.

Additionally, physicians express concerns about competition from newly independent PAs. Some worry that SB27 will encourage aspiring health care providers to skip medical school and residency, opting for attending a PA program instead. This shouldn’t be a concern. Currently, we do not have enough residency openings for medical school graduates, forcing many into other fields. And consider the differences in salary. The average physician earns $208,000 dollars per year, while the average PA earns $112,000. For most, medical school should still be worth it.

Health care provider shortages are a fact of life for too many people, but they don’t have to be. SB27 will help Utah to continue to be a leader in ensuring access to healthcare while maintaining a high quality of care for patients.

Conor Norris is a research analyst at the Knee Center for the Study of Occupational Regulation.

Edward Timmons is director of the Knee Center for the Study of Occupational Regulation

Conor Norris is a research analyst and Edward Timmons is director of the Knee Center for the Study of Occupational Regulation. Timmons is also professor of economics at Saint Francis University in Loretto, Pennsylvania.

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