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Major rule change allowing physician assistants to practice more freely in New York could be approved in state budget

  • / Updated:
  • Staff Report 

Governor Kathy Hochul has proposed making a COVID-19 pandemic rule permanent in her executive budget, ending an administrative requirement for experienced physician assistants (PAs) in the state. Officials with the state Health Department have expressed their support, stating that the change will help to strengthen the health workforce.

The original rule required PAs to practice primary care medicine under the supervision of a physician or doctor under certain circumstances, but former Governor Andrew Cuomo waived it in March 2020 via executive order. Hochul then extended the waiver under her administration, but the governor is now proposing to change state education law to end the requirement for New York PAs permanently.

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“A lesson learned from the pandemic is that we need a health licensure system that is flexible and can evolve as the practice of medicine changes,” said Health Department spokeswoman Monica Pomeroy in a statement on Friday. “The Fiscal Year 2024 Executive Budget includes provisions that would do just that.”

The proposed change would mean that certain experienced PAs could exercise at the top of their professional license and continue to address patient healthcare needs. Patti Cuartas, President of the New York State Society of Physician Assistants, has praised the proposal, saying it would remove burdens off overwhelmed physicians and PAs’ state licenses qualify them to responsibly care for patients. Cuartas also stressed that the change would expand care in rural and underserved areas that struggle to have or retain health care access.

However, physicians argue that their extensive education, training, and experience cannot be compared to a PA. Physicians are required to complete four years of medical school and medical residency for three to seven years with 10,000 to 16,000 hours of training, while PAs typically practice with 2,000 hours of clinical training and only have fewer than three years of medical school and no residency. The American Medical Association (AMA) claims that patients are 15% more likely to receive an antibiotic from a practicing non-physician and that non-physicians order more than 440% more X-rays and twice the number of biopsies for skin care.

Hochul’s proposal would modernize the scope of practice for health providers and continue new flexibilities health workers benefitted from throughout the pandemic, according to the Department of Health (DOH). Past executive orders lifting the administrative rule for PAs allowed health professionals to be flexible and rapidly respond to patient needs throughout the pandemic, according to the department.

According to the DOH, there are 29,453 licensed PAs statewide. A physician assistant in New York is authorized to prescribe, dispense, order, or administer items to complete a patient’s therapy, including prescribing medications or controlled substances, according to state law. The state law prohibits physicians from employing or supervising more than four PAs in his or her private practice at a time.

While the AMA data shows that fewer than 10% of PAs and nurse practitioners work in rural or underserved areas, Primary Care Development Corporation data shows that 47% of nurse practitioners and 40% of PAs practice medicine in Health Professional Shortage Areas compared to 36% of physicians.