Physician shortage affects older Americans' access to basic care

American Academy of Physician AssistantsOct 9 2009

During National PA Week, AAPA Raises Awareness of Legislative Challenges Preventing PAs from Treating Medicare Patients

As members of Congress debate what form a national health care plan should take, older Americans continue to suffer the consequences of a physician shortage that makes accessing basic care a struggle. Barriers to care could be greatly eased, however, by legislation that lifts restrictions preventing physician assistants (PAs) from treating Medicare patients.

PAs are licensed health professionals who practice medicine as members of a PA-physician team and are qualified to provide much of the same basic care as physicians. In many underserved communities, PAs are the only health providers for many miles and provide the bulk of primary care to residents. However, current laws limit their ability to provide much-needed services to Medicare patients, like ordering home health care or durable medical equipment. Passing legislation that lifts these restrictions could substantially reduce wait times for medical appointments, reduce travel for seniors who are ill, ease crowded waiting rooms and significantly improve the health of older Americans.

"Regardless of how health care reform unfolds, the physician shortage will continue to present real challenges in delivering care to America," said Stephen H. Hanson, president of the American Academy of Physician Assistants, which this week celebrates National Physician Assistants' (PA) Week. "The PA profession was created so that even in areas where doctors are few, patients can have access to quality care. Unfortunately, Medicare patients are denied this care because of outdated laws and unnecessary restrictions on a group of providers that stands ready to meet their needs."

Rancho/USC California Alzheimer's Disease Center stands as a model for how PAs can help expand services to seniors by working with an interdisciplinary team of physicians, nurses and therapists. The practice specializes in diagnosing, treating and caring for people with Alzheimer's and other memory problem disorders.

"Medicare regulations developed in the 1960s are simply not compatible with today's health care delivery system," said Freddi Segal-Gidan, senior PA at the California Alzheimer's Disease Center. "I've seen first-hand the unnecessary delays and disruptions in care that seniors face when PAs cannot provide the services and care older Americans and other Medicare beneficiaries need."

There are nearly 75,000 PAs in clinical practice today, and the Bureau of Labor Statistics expects that by 2020, there will be between 109,000 and 142,000 practicing PAs in the U.S. There were nearly 245 million patient visits to PAs last year, and PAs have prescribing privileges in all 50 states. However, PAs are underutilized in the current health care system. According to AAPA, health care reform that allows PAs to order skilled nursing facility care and provide hospice care for Medicare patients would make health care more efficient, cost-effective and patient-friendly.

National PA Week is observed each year October 6-12 by the PA profession. The week serves to celebrate the significant impact PAs have made and continue to make in health care, expand awareness of the profession and salutes the outstanding growth of the PA profession. AAPA seeks to promote quality, cost-effective, accessible health care and to promote the professional and personal development of PAs.