ALBANY — Lawmakers and physician assistants rallied in Albany last week for a bill they say would greatly expand access to healthcare and cut some of the red tape for a section of the healthcare industry in New York.
The bill they’re supporting would expand the number of assistants that a physician can directly supervise, from four to six. For the state prisons, a doctor would be allowed to supervise up to eight assistants, up from six.
MORE CARE, ACCESS
It would also permit PAs to write prescriptions without the direct input of a supervising physician.There are about 20,000 PAs in New York — medical professionals who do everything from research to primary care. While many work directly with licensed physicians, many operate their own private practices with remote supervision of a licensed physician.
In the North Country, there are many private practices run by PAs with no physician on staff. Kevin P. Bolan, who specializes in emergency and primary care at a private practice in Newcomb, Essex County, said his supervising physician hasn’t seen a patient at the Newcomb practice for nearly 30 years.
Bolan said he sees patients from all over the North Country, traveling upwards of 100 miles or more to make their appointments at his practice. He said allowing a doctor to supervise more PAs would help boost medical coverage in rural and urban areas alike.
“This will allow for more PAs to give more care and provide access, especially in rural and medically under-served areas,” he said.
FOUR PAS
Bolan said he sees a lot of mental health patients as well, and this bill would help to expand access to care in an area of the state that has very few providers capable of offering treatment for mental illness.
Bolan said that areas like the North Country often have only a handful of doctors for any one community, and when they’re limited to supervising just four PAs, that can mean the community is going without as many practitioners as necessary — and he said the act of supervising a PA isn’t as direct, or time consuming, as it may seem.
“The whole supervision thing, the supervision isn’t really there when the PA is practicing,” he said.
Bill sponsor Assemblymember Amy Paulin, D-Yonkers, said expanding the scope of PAs’ practice by allowing them to write prescriptions the way nurse practitioners are permitted to, and allowing for more PAs in a single physician’s supervision will go great lengths to improve healthcare in New York.
“It will alleviate hospital clogs, it will allow people to be discharged earlier, and it will improve overall healthcare for New Yorkers,” she said.
NEXT STEPS
The bill remains in committee in both the Senate and Assembly, with only a few voting days left in the session. Paulin said she thinks the chances of the bill moving to full passage in both houses is very good.
“We are resolving some amendments that we have been negotiating now for a couple of weeks with the state Education Department, (the Medical Society of New York), and of course the PAs, and I believe those changes will be reflected in an amended bill you may see as early as tomorrow,” Paulin said on Wednesday.
The bill was amended by Thursday, and could see action as early as Monday when the Senate and Assembly return to Albany for voting.
That amendment made a key change in the language of the bill. The original version would have authorized a PA who has completed 8,000 hours of supervised work to continue their practice without a supervising physician, essentially allowing them to run their own practice as an independent provider.
The Medical Society was critical of that move, and the amended bill does not permit a PA to practice without a supervising physician at all.
Bolan said the move would be a major step forward to expanding the number of practicing medical professionals in New York, and would come with minimal risks. A PA undergoes four years of medical training in graduate school, and after 8,000 hours of supervised practice would have spent a similar amount of time working in medicine to a doctor in residency.
Bolan said he sees the removal of that language as an unfortunate move.“It got taken out, but we’ll be right back here again next year fighting for it,” he said.