New legislation reducing restrictions on PAs has been proposed in several states struggling with access to healthcare and staffing shortages.
Jennifer Orozco, president and board chair of the American Academy of Physician Associates, spoke with Becker's about why more states should modernize the laws and regulations regarding how physician assistants and associates provide patient care.
She said physician assistants have been proven to provide high quality and safe care — as evidenced by the pandemic.
"Removing barriers for [physician assistants] and [nurse practitioners] at the time … was essential to save lives," Ms. Orozco said. "But we can't just do it during a crisis or during a pandemic; this is what is needed now. … [Physician assistants] are highly trained, educated professionals who have the ability to take care of patients in every specialty and setting — and then we have this health care workforce that's on a massive exit."
During the height of the pandemic, Ms. Orozco was in charge of provider redeployment at Chicago-based Rush University System for Health. This required her to relocate physicians, physician assistants and nurse practitioners to sites in need of staff and meet patient demand. Now, due to a return to tighter pre-pandemic restrictions, this is not an option.
"Everybody has different needs within their communities, and we have to empower those communities, and those [physician assistants] especially, to drive the care in those communities," Ms. Orozco said. "That's how patients do better."
While the workforce decreases, the population in need of quality care is increasing, according to Ms. Orozco.
"In this country, 99 million Americans lack adequate access to primary care," Ms. Orozco said. "One hundred fifty-eight million Americans don't have access to adequate mental healthcare. We have an aging population that is going to reach 80.8 million by 2040. In addition, we have a rise in chronic diseases like obesity. The reality is, unless we remove these barriers to physician assistant practice, we do not have enough people to take care of all patients."
To combat healthcare workforce shortages, new medical schools have been created and scholarships implemented to encourage more students to pursue a career in medicine.
However, Ms. Orozco believes this is not the most effective solution.
"We could create a million different medical schools — we'll never have enough," Ms. Orozco said. "[Physician assistants] have the ability to lead teams, they have [Master of Healthcare Administration degrees], they have [Master of Business Administration degrees], they have doctorates, PhDs, so do nurses, and so do other healthcare providers."
Many who are opposed to lessening restrictions on physician assistants believe it may hurt the quality of patient care. However, Ms. Orozco said decades of research proves that isn’t the case.
Ms. Orozco points to physician assistant success in providing care during the pandemic as the most recent case study supporting the quality of care physician assistants can provide.
"Change is hard," Ms. Orozco said. "In medicine, we are traditionalists, for lack of a better term, and there's a lot of good things to staying the status quo, right? This is how it worked. It worked in the past."
She said that many of the restrictions PAs work under were created in the 1960s and '70s and don't necessarily reflect how physicians and PAs practice medicine today.
"In most states, PAs are required to have a relationship with a specific provider, such as a physician," Ms. Orozco said. "I've been a PA for 20 years, and … I work with multiple vascular surgeons, but I have to pick one of them and file their name with the state. Unless I do that, I'm not allowed to practice at all. So, this really kind of limits flexibility of healthcare teams. I have to be tied to a specific person. It also limits access to care, which is, frankly, where patients are suffering the most right now."
She notes that with the rise of the internet, growing patient needs, corporate medicine and healthcare system mergers, medicine has changed drastically since she started out as a physician assistant 20 years ago. But while change can be a lot to adjust to, it's necessary for better quality of care.
"We can't afford that way of thinking anymore, because it's the patients who are suffering," Ms. Orozco said. "So we have to change, and if you want change, you have to change something."