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State Laws Tilt in Favor of Advanced Practitioners

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We’ve written before about the legislative battles surrounding the expansion of physician assistant and nurse practitioner roles, but it should be noted that in most parts of the country, the battles are trending in favor of PAs and NPs.

Two articles, one from Missouri and one from Washington, highlight this fact.

According to Michele Munz at the St. Louis Post-Dispatch, the current state law requires physician assistants to “be supervised by a doctor located within 30 miles of where they practice, and a doctor must be present 66 percent of the time they are caring for patients…”

This state law, however, “will change Aug. 28 when the supervising doctor will be allowed to be up to 50 miles away and will have to spend only half of a day on site for every 14 days the physician assistant practices.”

As far as trends go, it’s interesting that the Missouri law being changed was “the second-most restrictive state law in the country.”

Munz writes that loosing these restrictions on physician assistants could provide higher quality, more affordable care to Missouri’s rural patients, and it could ease the burden and long waits that many clinics, already chronically understaffed, are experiencing.

“Allowing physician-PA teams to tailor medical care according to the needs of their patients and communities can only lead to better access to care in rural and underserved areas,” Paul Winter, physician assistant at Missouri Baptist Hospital and president of the Missouri Academy of Physician Assistants, said.

Over in the state of Washington, a slightly different change was enacted when “a new state law that took effect [the last week in July]…allows more physician assistants to work with doctors,” Valerie Bauman of the Puget Sound Business Journal reports. Now, physicians will be allowed to supervise five assistants and the law “no longer requires physicians to be on site for 10 percent of the time that a physician assistant is practicing medicine.”

“The change could help mitigate the shortage of primary-care providers that’s anticipated next year when the state expands Medicaid and other health reforms kick in,” Bauman explains.

And it’s not just Missouri and Washington discussing the loosening of restrictions on extenders. Other states, such as Texas, California, Pennsylvania, Minnesota, New Jersey, and Massachusetts, are also reexamining their laws.

As physician assistants and nurse practitioners who are looking for jobs, what are your thoughts on these developments? To the physicians who are reading this and unsure about the wisdom behind these laws, how would you as extenders bridge the gap and ease their concerns about your expanded authority?

Physicians, what do you have to say to NPs and PAs about your concerns? Are these conflicts between the two groups, physicians and extenders, as severe as the news would have us believe, or has the conflict been hyped by the media?

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