Various areas of the healthcare sector have been impacted by the COVID-19 pandemic in different ways. Emergency departments and ICUs are desperate for registered nurses and doctors. Private practices and public clinics are furloughing clinicians due to nonessential medical procedures being delayed. In all of this, many physician assistants (PA) don’t know where they stand.
Some PA jobs are stuck in limbo while employers and regulators try to figure out how to best utilize their services. Much of the frustration these days is related to states with rules restricting how PAs can normally treat patients. Like nurse practitioners, PAs in many states can only work under the direct supervision of a physician.
Health Jobs Nationwide says that PAs could prove vital to addressing growing COVID-19 caseloads. But their usefulness is limited in states that restrict their practices. Even if there are enough PAs available, there are not enough doctors to supervise them effectively. Thus, PAs who could otherwise lend a helping hand are being left on the sidelines.
A March 25 piece published by Wisconsin Public Radio highlighted the plight of one particular PA who finds herself out of work. Her employer, a group practice in Oshkosh, began asking her to reschedule her appointments when the COVID-19 virus first arrived. Weeks later she found herself with a completely free schedule after having bumped everything into May and June.
Hoping to pick up some supplemental work, she contacted a healthcare staffing company looking to recruit PAs to provide telemedicine. The recruiting agent told her that she did not qualify because restrictions in Wisconsin prevented her from participating in the program without doctor supervision. At the time, the agency did not have enough doctors available to take on more PAs.
Wisconsin rules require PAs to be supervised by physicians. Unfortunately, a physician is allowed to supervise no more than four PAs at a time. If the recruiter doesn’t have enough Wisconsin licensed doctors to take on more PAs, then that’s that. They will not be able to utilize Wisconsin PAs for the telemedicine program.
The most frustrating part of all of this is that physician assistants jobs are restricted in 39 states. Some states are more restrictive than others. Regardless, we have an army of medical professionals who appear to be more than qualified to handle telemedicine visits and diagnose possible COVID-19 symptoms. PAs can already handle primary care and write prescriptions under normal circumstances, so this should be no different.
A lack of flexibility in state regulations has created a situation in which precious skills and knowledge are being left on the table. It doesn’t make any sense. A PA trained as a generalist should have the flexibility to step in when emergency circumstances dictate. The same goes for a PA with intensive care experience. She ought to be able to step in and help even if there isn’t a doctor to supervise her.
The other frustrating issue is that many states do not allow PAs to change their scope of practice to meet current needs. Changing one’s scope is a time-consuming process requiring a certain level of approval. By the time some PAs complete the process and find new supervising doctors, the worst of the crisis could be over.
All of this is to say that there are physician assistants sitting around with nothing to do. Their jobs are in limbo because their clinics have shut down and they cannot go to work for hospitals or telemedicine providers. Thus, their skills are being wasted. It is truly a shame.