The Alaska State Medical Board is changing the regulations which regulate how physician assistants, or PAs, work within the state. In a recent hearing on the changes, which were open to all, nearly 30 witnesses were present to testify. Everyone were vocal about the proposed rules.
John Western, a PA who is employed at the North Slope, said the regulations will create ineffective barriers and limitations.
“There’s an urgent shortage of healthcare providers and patients will get in pain and suffering, and eventually die due to the shortage of PAs” Western said.
People who voiced their displeasure over the rules included PAs doctors, PAs and health administration officials. A lot of people expressed their anger and worry about what the rules could affect health treatment in Alaska.
The proposed regulations would raise the number of direct supervised hours needed before PAs can be employed in remote areas up to 2,400. It’s roughly 14 months of education which would need to be conducted in an urban setting. Based on the way that the rules are designed, a remote area is a large portion of the state that is beyond Anchorage.
Teresa Lowe, a physician assistant and coordinator of the campus of UW’s PA course in Alaska she lives in Anchorage however, she grew up within Mountain Village. She’s worried that the new regulations will force PAs away from rural areas.
“This could significantly decrease the enthusiasm people show for moving to remote regions,” Lowe said. “It is utterly damaging to the potential we have due to the sheer number of individuals who are eager and have great enthusiasm to go out into remote Alaska. However, in just 14 months there is a lot that can change.”
Physician assistants have the ability to identify and manage patients. They are supervised by medical professionals. Their education usually includes three years of school and hands-on training.
Lowe admitted that despite more than 10 years of experience, should she decide to resume clinical work in the future under the proposed regulations, she’d need those 14 months of instruction in a new way. She added that this is the case for PAs looking to shift their focus and has done it often throughout her professional career.
“One of the things that’s advantageous about working as an PA is that you can make changes,” Lowe said. “I’ve been an forensic examiner on our team for sexual assault. I’m now teaching. I’ve been in occupational medicine and emergency care, and emergency. I have a wide range of knowledge.”
Another change proposed would mean PAs can only practice under the expertise of their supervising doctor, regardless of whether they have other knowledge or have completed a course. Therefore, if the PA had experience having worked with an OBGYN, or worked as an EMT however their doctor of choice didn’t possess the required skills, they can’t utilize that experience to treat patients, even in a crisis.
The members from the Alaska State Medical Board declined to answer any questions about the proposed regulations as the regulations are available to public comment until Oct. 3. In a brief email statement that was sent out by the department of state that manages the board stated “The project was completed in two years and the changes proposed that are currently open for public comment are the result of this process.”
At least three of the largest health-care associations in Alaska have expressed their displeasure with the plan as it is written.
Jared Kosin, president and CEO of the Alaska Hospital and Healthcare Association stated that PAs are at the frontline of providing healthcare to rural areas and the changes could mean catastrophe for the rural population.
“We are prepared for a major disruption, because it would mean cutting people off the line, making it significantly more difficult and longer to recruit candidates who are qualified all the way to the point of being qualified,” said Kosin.
In the United States, there is an effort to simplify the regulations for PAs to enhance their independence. However, Kosin stated that Alaska is more cautious than other states and the new regulations seem to limit independence, but rather than increase it.
The Alaska State Medical Association, which is primarily a representation of physicians in Alaska, has helped in the creation of an earlier version the rules. The executive director of the association, Pam Ventgen, said that some of the changes are required. They’re intended to ensure PAs are able to gain experience on the job before they can practice independently in rural areas, and also to make sure that PAs are able to inquire about issues with experts in that field. However, she added that the organization doesn’t like changes to their current version. She pointed out that one thing that’s not in the regulations is the flexibility.
“If an aide to the community worked for ten years as healthcare aide in a community, and then went to PA school, graduated and decided for a return visit to their community to work as PA, then as PA this makes complete sense for me.” Ventgen said. Ventgen.
And Ventgen declared that it’s crucial to change the regulations to permit the PA to make use of their complete skills in the event of an emergency. Ventgen cites the instance of a patient going into labor while a PA is the only healthcare professional who has OBGYN expertise.
“In an emergency situation, that’s more than enough,” said Ventgen. “It’s superior to the taxi driver who is in an empty parking garage, therefore there must have a reason for this photo. “
The board will discuss the changes during their quarterly meeting in November. 17. If they are approved the current version the rules could take effect within 30 days.
