Q&A with Past President of the PSPA, Kathryn Martin Discusses New Law Allowing Osteopathic PAs in Pennsylvania to Prescribe Medicine
Kathryn R. Martin, PA-C, received her degree from the Hahnemann University PA Program in 1984. She has been a family medicine PA for 25 years and has also recently started working part-time in pediatrics. She is a Past President of the Pennsylvania Society of Physician Assistants (PSPA), having served as President from July 2005-July 2007. Martin is also the PSPA Liaison to the Bureau of Professional and Occupational Affairs (BPOA) and also the Pennsylvania Osteopathic Medical Association (POMA). Here, she speaks about the recent passing of a law allowing osteopathic PAs to prescribe medicine in the state of Pennsylvania.
Q: Can you elaborate on the law in favor of osteopathic PAs being able to write prescriptions in Pennsylvania?
A: On August 8, 2009, the final regulations giving Prescriptive Authority to Physician Assistants who are supervised by Osteopathic Physicians (DOs) were published in the Pennsylvania Bulletin. These approved rules allow PAs to prescribe and dispense medication, including controlled substances. The supervising physician decides which categories of medication that the PA can prescribe and has to send in a signed Prescriptive Authority Agreement to the Osteopathic Board for approval before the PA can begin writing prescriptions.
Q: Why do you think it’s important for PAs to be able to prescribe medicine?
A: It is important for PAs to be able to prescribe medication because, as mid-level providers, we can take histories, perform examinations, order diagnostic tests and make a diagnosis, so it makes sense that we should therefore be able to treat the patient as well. Up to this point, a PA working for a DO had to present the patient’s case to the supervising physician after examining the patient and the DO wrote the prescription. This definitely slows the flow in an office or other setting and probably has discouraged some DOs from hiring PAs in the past.
Q: Why is this such a large step for PAs in Pennsylvania?
A: This is a large step because PAs who work for DOs in Pennsylvania have been the only PAs in the entire country who did not have prescriptive authority until now. PAs who work for MDs in Pennsylvania have been writing prescriptions since 1993.
Q: How does the passing of this law affect the PA profession as a whole?
A: Now all PAs in all 50 states can prescribe medications, so this achievement should be noted for the history of the PA profession.
Q: Has trying to get this law passed been an in-depth process? How did PAs in Pennsylvania advocate for this?
A: It was a very in-depth process that this regulation went through to get to the point of final approval and publication. It took over four years to get to this point. The PSPA advocated for this regulation by sending representatives to attend the monthly Osteopathic Board meetings in Harrisburg. PAs and DOs in Pennsylvania also wrote letters to their legislators in support of this regulatory change.
Q: How do you think the passing of this law will benefit patients?
A: The passing of this law will benefit patients because it will increase access to care, especially in under-served areas. The PA must have a supervising physician, but the physician does not have to be on the premises, so the PA can be seeing patients while the doctor does rounds at the hospital, nursing home, etc., yet be available to the PA by phone if needed.
Also, in Pennsylvania in particular, practices are having a hard time attracting physicians, so a PA can fill that need, especially now that the DO can delegate prescriptive authority to the PA.
Q: Why do you think PAs are such an important part of the healthcare industry?
A: I think PAs are an important part of the healthcare industry for many reasons. Chiefly, we are very well based in primary care, which is a huge need in this country right now and will be well into the future since shortages in primary care physicians are projected. PAs also have the flexibility to move into areas of need if physicians are willing to train their PA beyond the primary care role.
We provide cost-effective, quality care, and although we function autonomously, we also work with physician supervision and are dependent providers, so physicians do not need to feel threatened by our profession.
Q: What do you see for the future for PAs? How do you see the profession growing and evolving even more?
A: I see a bright future for PAs now in Pennsylvania because I believe more DOs will hire PAs, but also for PAs in the whole country. Much of the talk about healthcare reform involves wellness programs to avoid diseases in the first place and chronic disease management programs to keep patients with chronic illnesses as stable as possible and avoid complications. This is the perfect place to utilize PAs. We are trained to teach patients how to keep themselves healthy and how to manage conditions like diabetes so we can be on the front lines with the new reform initiatives. We still have some barriers to our practice, particularly as far as reimbursement goes, but now is the time to educate our legislators about PAs and how we can help to improve the health of this nation. I think they will be willing to remove some of those barriers when they see what we can do as a profession.
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