Massachusetts PA bills are a step in the right direction, PA org president says

New legislation in Massachusetts would allow physician assistants to practice with fewer restrictions. 

A series of bills, if passed, would allow PAs to authorize psychiatric holds, practice without a supervising physician and work in limited service clinics, such as CVS MinuteClinics.

PAs were allowed to practice without a supervising physician following an emergency executive order filed during the pandemic, but it has since expired, according to Duncan Daviau, PA-C, president of Massachusetts Association of Physician Assistants. 

Making the executive order permanent, he said, would make providing patient care more efficient. 

"A lot of times, certain hospitals require co-signatures because we have a supervising physician, or they require a certain number of chart audits with your supervising physician," Mr. Daviau said. "[This] would eliminate some of those barriers. We would spend less time doing paperwork and doing emails and chasing people down to get these checkboxes done." 

Additionally, he explained that in the event a PA's supervising physician has left, it can be difficult and time-consuming to find a new physician — which can needlessly delay patient care. 

"Once a PA has been well trained and has been working in a specialty for one period of time, I don't think they need to have every single chart reviewed or all these administrative barriers that are unnecessary," he said. 

Under new legislation, PAs would also be allowed to place patients in an involuntary psychiatric hold. Physicians, nurse practitioners, social workers and police officers are currently the only professions able to do so. 

"In Massachusetts police officers … they on average have about 12 hours of mental healthcare training," Mr. Daviau said. "I, as a physician assistant, have hundreds of hours worth of mental healthcare training. I can prescribe psychotropic medicines, I can see psychiatric conditions such as depression and stuff like that and treat it. But the fact that I can't sign off on this order is a detriment to our healthcare system — and to our patient population as a whole."

PAs would also be allowed to practice at limited service clinics as nurse practitioners do. 

"In other states, they frequently do." Mr. Daviau said. "We've actually had some conversations with some of the executives at CVS who are very supportive of this. So, we've been trying to push this for the last two or three legislative sessions."

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