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New bill would change dynamic between physicians and physician assistants, improve healthcare access

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DENVER -- State lawmakers will consider a bill to change the current language defining the relationship between a physician and physician assistants, something the bill's sponsors say will increase healthcare access for patients, especially those in rural areas.

Current law requires experienced physician assistants to be supervised by a physician after their first three years of practicing as a PA, and an additional two years of supervised clinical practice when changing specialties.

House Bill 21-1184 would change the dynamic, by updating the term "supervision" to "collaboration." It would also eliminate the supervision requirement.

"Supervising is implying that they're directly observing you and that they're kind of giving the orders and you're carrying them out," Cooper Couch, who's a certified physician assistant, told Denver7.

"We collaborate with physicians, we have a 27-month master's degree, some programs are even longer than that, and are trained in the medical model alongside physicians. And so we have the education and training when we graduate to collaborate with physicians based on what we've already been taught, usually right alongside physicians and their own training," Couch said.

Those supervisory requirements require physicians to sign off on anything from a chart review, to a patient's prescription. That's an especially irksome regulation when the physician isn't in house.

"If my physician decides to leave, or if she dies, unexpectedly, or something happens, where she can't perform her duties and is unable to practice anymore, right, now, we would have to find another physician, and there would be hundreds of patients that are delayed care."

Only 13% of PAs in Colorado practice in rural areas.

Couch practices at a clinic in Canon City, a rural area in Fremont County. He told Denver7 he's one of three bilingual providers in the county, but notes the others are also not physicians. His practice has also been looking for a family physician for the last six months.

The bill is supported by the Colorado Academy of Physician Assistants, the Colorado Community Heath Network, the Home Care and Hospice Association of Colorado, UFCW Local 7, and numerous PAs, physicians, nurse practitioners, and health centers.

Couch, and several other PAs testified before the House Health and Insurance Committee Wednesday afternoon.