Needed in COVID-19 Crisis: Physician Assistants

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Dispatches from PAs, or physician assistants, from the front lines of the COVID-19 response have been flooding my phone and inbox for the last few weeks. As president-elect of the American Academy of PAs, I’m constantly connected to a network of PAs. And what I’ve heard is disturbing.

Like other health care providers, PAs are under a lot of strain. Those who are part of the COVID-19 response have to contend with shortages of personal protective equipment (PPE), fear for their own lives and the risks they take by returning home to their families after work.

The PAs, who aren’t on the front lines, have different concerns: They worry that they might lose their jobs or, on the other extreme, might not be able to join in the life-and-death response to COVID-19.

At the moment, keeping our front-line providers safe must be the top priority. But for those medical providers who want to contribute but can’t because of red tape, we need to make sure that they are empowered to pitch in.

As more health care workers contract COVID-19, or simply need a mental or emotional break, we will need more hands to manage this crisis. There are more than 140,000 PAs in U. S., practicing in every medical setting and specialty. They are ready and willing to do so. PAs are trained as medical generalists, meaning they have medical knowledge beyond the setting and specialty in which they work, and can treat the “whole patient.”

Yet, at this critical time, some PAs are prevented from practicing to the full extent of their education, training and experience in most states because of outdated regulations. This is because they are tied, by law, to a specific physician. This regulation can limit PAs’ flexibility, preventing them from working in different practices or settings during an emergency. And what we are dealing with right now is clearly an emergency.

Simply put: At a time when all hands are needed on deck, too many members of the PA profession have their hands tied.

PAs are qualified medical professionals who diagnose illness, develop and manage treatment plans and often serve as a patient’s principal health care provider. It only makes sense to allow them to practice medicine at the top of their education and training, free of bureaucratic handcuffs.

But with many state legislative sessions on hold because of the coronavirus, governors should take on this problem and temporarily waive requirements for PAs to have supervisory or collaborative agreements with physicians. They can do so with a simple stroke of a pen.

That’s what governors in six states have already done. Pressed for time, they knew they needed more medical help, including from PAs. Maine, Michigan, New Jersey, New York, Louisiana, and Tennessee have waived those requirements as part of their response to COVID-19. Twelve states have previously waived physician supervision requirements for PAs during emergencies or disasters.

The PA profession is fighting to keep its members and their families safe. At the same time, we are battling for patients who need care during this difficult time. It is crucial that policymakers allow more PAs to put their training and experience to use where it’s needed most.

Dr. Beth R. Smolko, DMSc, PA-C is Director of the PA program at Frostburg (MD) State University (MD) and president-elect of the American Academy of PAs.

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