Dermatologists/PA’s/NP’s Win 1st Battle
by Juhan Mixon, Jan. 23, 2004

The Florida Senate Health Care Committee on Wednesday, January 21, 2004 passed Senate Bill 1124 (SB1124) with exemptions for physician assistants and advanced registered nurse practitioners from being placed under direct supervision when working for a dermatologist. Had this bill passed, Florida would have been the only State in the U.S. with such restrictions on PA or NP practice. It would also have sent a signal to others to restrict practice specialties.

The bill which was sponsored at the request of the Florida Society of Dermatology and Dermatologic Surgery split dermatologists throughout the state. The contentious point of the proposed legislation was direct supervision of PA’s and NP’s. The Senate sponsor, Senator Durell Peaden, M.D. told the Florida Academy of Physician Assistants that he wanted to hear from physicians on this issue; and hear he did! Dermatologists across the state, some former officers of the Society, responded in writing urging the Senator to withdraw his bill or for the Committee to vote it down. Most suggested that physician extenders play a vital role in delivering quality health care. They also advised that this bill would restrict their practice setting unnecessarily.

While the Academy agreed with the FSDDS that a few doctors and PA’s should be reported to the Board of Medicine for practicing below the standard of care, we along with many dermatologists felt the proposed legislative solution went too far. The unintended consequences of such a bill were numerous. They included closing satellite clinics, increasing patient wait time and causing patients to go to practitioners who do not specialize in dermatology.

Both sides lobbied hard for two weeks. In addition to the e-mails, faxes, calls and letters from derms to Senators, several Physicians and Physician Assistants were instrumental in assisting us in this effort. Pat and Juhan Mixon, lobbyists for the FAPA, were prepared with patient satisfaction surveys, articles on “wait time” for patients, data on shortages of dermatologists and a power point presentation to drive home the need to exclude PA’s and NP’s from the legislation.

Moments before the bill was to be debated, legislative staff approached the FAPA team and asked if the direct supervision for PA’s and NP’s were deleted would we support the bill. After consulting with the presenters and the Nurse Practitioners who were also going to speak, we agreed and the bill passed without objection (11-0).

Now we need to begin working to defeat the bill in the House of Representatives. Within the next few days we will let you know the entire House strategy. In the interim, please write and ask Representative Frank Farkas, Health Care Chairman, Representative Shelley Vana sponsor of the House bill to withdraw or not agenda House Bill 367. Their e-mail and fax addresses are:

farkas.frank@leg.state.fl.us; (727) 893-9857
vana.shelley@myfloridahouse.com; (561) 640-6123

Please stay in touch with this web site for additional updates on this critical issue.