Physicians Assistants, or PAs, may soon have more opportunities to practice in Missouri. A bill headed to the Governor’s desk would provide more flexibility in how and where they provide care.Physicians Assistants are trained health workers who practice medicine under the supervision of a doctor. Their training is shorter than that of a doctor, but they do exams, prescribe drugs and diagnose and treat illnesses.
Missouri currently requires a doctor to be onsite supervising a PA two thirds of the time. That’s the strictest PA rule in the country, second to South Carolina, according to Paul Winter, a PA in St. Louis and president of Missouri’s physician assistant association.
Winter says the rule discourages PAs who train in Missouri from staying and practicing in the state.
“Currently, about 50 percent of the graduates are leaving the state, and most of that is due to the job market,” says Winter. “A lot of that has to do with the restrictive language of our laws.”
Winter says passage of HB315 changes this dynamic by cutting the amount of onsite supervision time required by doctors. The new legislation specifically requires that Physician-PA teams practice in the same physical location one half day for every 14 days the PA is practicing. The doctor must still be available by phone or some other means of communication at all times.
Winter says the resulting increase in PAs in Missouri and ease at which they could practice would be a big boost for rural communities facing physician shortages, as well as for doctors who struggle to keep up with growing patient demands but can’t afford to bring in another doctor.
“This is a chance to hire a mid-level [a PA] and help them meet their patient load needs,” says Winter. “I think many of us can relate to waking up and feeling sick, missing a couple days of work and then calling your doctor to get in. And then they give you an appointment three weeks from then.”
The changes also put PAs more in line with what’s required for nurse practitioners.
The state’s medical association is on board with the legislation, too. A spokesperson with the group says the current rules are burdensome for doctors. The new bill would also require that PAs practice in the same specialty as their supervising physician.
Missouri has two Physician Assistant certification programs. One is at St. Louis University and the other is at Missouri State University in Springfield. The University of Missouri-Kansas City is slated to open a PA training program in January.
This story is part of a reporting partnership that includes KCUR, NPR and Kaiser Health News.