South Carolina could loosen restrictions on physician assistants, state APA co-chairs say

South Carolina lawmakers have introduced Senate Bill 553, which would allow physician assistants with 6,000 hours of training to practice without a supervising physician. 

Currently, physician assistants in the state must work under physician supervision with a ratio of one physician for every six physician assistants or nurse practitioners. 

They are also limited in prescriptive authority for controlled substances and cannot volunteer for health fair events, camps and disaster triage without physician supervision.

The new bill will still require physician assistant graduates with less than 6,000 clinical hours to be supervised, and will require 1,000 hours of training if a physician assistant changes specialties. 

The legislation will also hold fully trained physician assistants — not supervising physicians — solely responsible for any legal matters related to the care they provide and would allow physician assistants to prescribe controlled substances. 

Jennifer Marshall, PA-C, and Megan Fulton, DMSc, PA-C, co-chairs of the legislative committee of the South Carolina Academy of Physician Assistants, told Becker's how the bill will impact physician assistants and patient care if passed. 

"It is well known through [state] data that we have a current physician shortage, which will become even more complex in the next five years," Ms. Marshall and Ms. Fulton said. "This not only means there are not enough physicians to see patients, it also means it can be difficult to identify a supervising physician, which severely limits the ability for physician assistants to provide care in rural areas. The ability for physician assistants with 6,000 hours of experience to see patients without requiring a supervising physician will remedy these challenges."

Passage of the bill will help streamline patient care in the event that a supervising physician cannot be acquired in the event of death, retirement or illness, particularly with physician-owned practices, they added. 

"We have many examples of clinics that are manned with one physician and one physician assistant," Ms. Marshall and Ms. Fulton said. "If the physician suddenly falls ill or retires, based on current law, the physician assistant is unable to continue practice without finding another supervising physician. This can be challenging and very time consuming, leaving patients with no healthcare provider. With the passage of [Senate Bill] 553, the experienced physician assistant would be able to continue seeing patients with no gap in care."

Hospitals would also benefit from the new bill, according to Ms. Marshall and Ms. Fulton. 

"Currently, every time a physician leaves, cumbersome paperwork must be completed to update the physicians listed on the physician assistant license," Ms. Marshall and Ms. Fulton said. "If the paperwork is submitted incorrectly, even with minor technical errors, the physician assistant cannot work for a minimum of 10 days. This decreases patient access to care and burdens the other providers to cover during this time when the only thing that changed was the name of a physician."

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