SC bill would allow certain physician assistants to practice without supervision of a doctor

Correction: the broadcast version of this story called it a “physician bill.” The legislation is about “physician assistants.”

GREENVILLE, S.C. (FOX Carolina) - Currently, physician assistants can diagnose illnesses, prescribe medications and manage treatment plans, but they do so under the supervision of a doctor. Senate bill 553 would allow physician assistants with at least 6,000 hours to practice without the supervision of a doctor. Advocates say this would help address the doctor shortage, but opponents say there are better solutions.

According to the Kaiser Health Foundation about 2 million people in South Carolina live in healthcare professional shortage areas. Zach Sutton is a physician assistant in Greenville. He says many of his patients drive hours just to come to the practice he works at. If this bill is approved, he says it would make it easier for more PAs to be located in rural areas.

“I think as COVID showed us, a lot of areas in South Carolina are underserved,” Sutton said. “Health systems have found that there are certain areas where patients weren’t getting as good of care. I think this update can only help better prepare us and allow more physician assistants to get to some of these areas.”

Jennifer Marshall is the co-chair of the legislative committee of the South Carolina Academy of Physician Assistants. She says PAs would still have to collaborate with physicians and refer patients as needed.

“A lot of rural clinics will only have one physician and one PA,” Marshall said. “If that physician falls ill or suddenly retires, that PA can’t work any longer unless they find a supervising physician. This law would allow that physician to retire and the PA could continue to see patients without having to find another physician to sign off.”

But not everyone is in support of the bill. Physicians for Patient Protection says doctors usually have to complete 15,000 hours of clinical work before they can get their license. PPP President Dr. Rebekah Bernard believes 6,000 hours for a PA is not enough and could put patients at risk.

“It doesn’t really make sense to say a doctor has to complete this minimum or they are not safe to practice medicine, but now we are going to allow a different professional to do that same amount, the same type of care, but in half as much hours or potentially even less,” Dr. Bernard said.

Dr. Bernard says there are alternative solutions to the doctor shortage. She points to government funding for medical students after they graduate and start looking for resident opportunities. This is typically when they work in a hospital setting.

“The physician shortage was manufactured back in the 1980s,” Bernard said. “There was this idea that there were too many physicians being produced. Different government entities decided that they need to slow down the government supply. In 1997 they froze funding for residency training.”

Bernard says this freeze has caused a limited supply of residency spots.

“This is match week and in fact we just found out that there will be 2,500 students, who all they can do is wait until next year to apply again for residency,” Bernard said.

The Resident Physician Shortage Reduction Act was proposed in 2021. This would have funded 14,000 residency positions over seven years nationwide. But it has not passed.

“The number one way to fix the physician shortage is to create more physicians,” Bernard said. “We can create more physicians if we fund and create those residency spots.”

SC Senate bill 553 has been referred to the committee of medical affairs.

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