Legislators in New York are pushing for a bill that would make permanent a state executive order that has allowed physician assistants to practice without a supervising physician since March 2020.
This only extends to PAs who have more than 8,000 hours of experience and work for hospitals, large healthcare organizations or in primary care.
The Public Health Emergency order, which originated during the pandemic, is set to expire in May, which could significantly impact patient care access according to Patti Cuartas, PA-C, president of the New York State Society of Physician Assistants.
Prior to the pandemic, New York PAs were assigned to a single supervising physician. In outpatient facilities, one supervising physician would have four PAs. Inpatient facility supervising physicians had six PAs.
"If two of those PAs are out, because one is on maternity leave and the other one, let's say, got hurt, they can't be replaced because of the ratios," Ms. Cuartas said. "It makes no sense."
Current legislation requires supervision of physician assistants to be continuous, but it does not have to be on site.
"If you're working in the emergency department, [you] don't always work with the physician who's on paper," Ms. Cuartas said. "We have a friend, a PA, who has never in seven years worked with the physician who is on paper with her."
She added, in her own experience working in an emergency department, PAs often work with whomever is there and as a team.
"It's just an administrative burden," Ms. Cuartas said. "We want to make sure that what we're doing day to day to take care of patients is actually mirrored in the legislation."
PAs in the state are currently allowed to prescribe all scheduled drugs and medications but are not allowed to prescribe durable medical equipment. The new bill would allow PAs to do so.
"I know how to set somebody's broken bone, but I can't write a prescription for the crutches," Ms. Cuartas said. "So, the legislation … basically allows us to write for durable medical equipment [like] crutches, wheelchairs [and] diabetic shoes … a lot of cleanup of legislation."
The legislation will also permit PAs to work in schools as nurses do.
"PAs [during the executive order] could be moved around in a hospital setting or a healthcare organization setting to go where the need was the most without having to worry about which physician they were tethered to," Ms. Cuartas said. "It doesn't mean that we're not going to work with physicians. It doesn't mean that we're going independent … Our scope of practice is not being broadened, because it's already broad … We are trying to fill a need in the workforce shortage."