Questions
by Eric Smith, PA-C
FAPA Secretary

I have received many questions from PA’s throughout the state asking about expansion of PA privileges. Most of these questions inquire as to when we are going to obtain controlled substance privileges in the state of Florida or when our co-signature requirements will be eradicated. I’m sure many of you reading this article right now would like to know the answers to those questions. If you are one of those people, hopefully the rest of my article will help you understand why these questions remain unanswered.

Not too long ago, the Academy Leadership sent out emails and correspondence to PA’s and FAPA members throughout the state of Florida asking them to let us know what issues that they would most like to be dealt with in the upcoming legislative sessions. This feedback will help us guide the future direction of our profession in Florida so that we will be tackling those issues most important to those of you out there practicing medicine. But it must be understood that it takes careful and patient planning to bring these issues into legislation. Any premature miscalculation could backfire horribly on the PA Profession and result in backlash from major physician groups in Florida. This is just the kind of thing we don’t want to happen.

That leads us to the question of “why do we have such backlash?” Why are certain physician groups poised to further restrict our field than it already is? For the past few years, our Academy and our heroic legislative lobbyist team (Pat and Juhan Mixon) have fought and won major battles against groups attacking our rights. Major legislative bills, one after the other, have continued to appear in the state legislature riddled with restrictive and sometimes offensive language aimed at midlevel providers. Up to this point, we have been able to kill these bills with help from the Mixons as well as headstrong grassroots PA’s who didn’t hesitate to approach their congressmen and defend our rights. But the attacks continue and our fight goes on, each time more complicated than the time before. And all we want to know is “why?”

That answer is an elusive one. Ask a proponent of one of these physician groups proposing legislation against us, and he may tell you that there are liability concerns in cases of PA’s who were not well supervised. So you may ask this person for specific case examples. The stark reality is that you will not find many. In fact, our own research has shown that PA’s have fewer malpractice or liability case involvement that any practitioner group in the state of Florida, including physicians and ARNP’s. I believe that is a testament to our strong training and our own realization not to cross the boundaries of our scope of practice. PA’s for the most part are well aware of what they can and can’t do in clinical practice, and they are well aware that they are an integral part of the Physician-PA team. We do not seek privilege expansion to get independence from that team concept… we do so to strengthen that team concept, with the ultimate intent to help our patients. At a time when there are healthcare shortages and long waiting room lines at doctors offices, why would anyone want to further restrict what a PA can do for the physician that they work for?

Physicians who employ or know PA’s understand this and they support us for the most part in our fights. Usually the physicians attacking us are the ones who do not understand our purpose in healthcare and feel unnecessarily threatened by our presence. That perceived threat is what leads to these attempts at restricting our rights, all the while accompanied by unsubstantiated reasons why we need to be more directly supervised in everything we do.

Despite all this, PA privileges in the state of Florida have continued to expand in a consistent manner these past few years. Just check out the “Academy Milestones” section of our website at www.fapaonline.org. There have been several remarkable legislative strides made, especially in 2005 alone! Little by little we are “closing the gap” in our field of midlevel practice, enabling us to serve our physicians and our patients better in the practice of medicine.

So the final question we now must answer as PA’s in Florida is “what can I do?” If we look at the fact that all the aforementioned attacks on our profession have been the result of physicians and legislators being uneducated as to what our purpose really is or what our training really entails, then the answer is clear. We as PA’s must also be educators. We all must get actively involved within FAPA by first becoming members (to support the hard work being done to protect our rights, retain our privileges and improve our accessibility to patients), and secondly by getting involved in local leadership positions (i.e. Area Representative, Liaison positions, or FAPA Committees) to help us educate these physicians and legislators. If you are a PA in Florida who wants controlled substance privileges or wants elimination of co-signature requirements, your help and involvement could be crucial in helping us reach such goals.

Physician Assistants are not a threat to healthcare. They are a big part of the solution to the healthcare crisis that has impacted Florida and much of the United States. Once we can help others understand that, our world, our physicians’ world, and our patients’ world will be a better place. And there will be a lot fewer questions!

Posted 2/20/06