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COMMENTARY: Physician assistants can help Nevada overcome rural health care access issues

This is a pivotal moment for Nevada when it comes to health care.

A 2017 report, “Health Workforce Supply in Nevada,” evaluated the supply of physicians, nurses and other health care workers in the state. Alarmingly, they found that the health care workforce in Nevada is in bad shape.

Ranked among U.S. states, Nevada comes in 48th for the number of physicians per capita, with just 245 physicians per 100,000 residents. And when it comes to primary care, the outlook is even worse: Nevada is ranked 50th, with just 88 primary care physicians per 100,000 residents.

According to the report, “it is abundantly clear that Nevada’s health workforce supply falls well short of national averages for most of the key professions needed to ensure access to basic primary, preventive, and specialty services.” And the situation could become even more desperate as the state’s population grows and ages over the next few years.

Enter physician assistants.

Physician assistants, or PAs, are medical providers who diagnose illness, develop and manage treatment plans, prescribe medications and often serve as a patient’s principal health care professional. There are 123,000 PAs in the United States, and more than 875 PAs work in Nevada. PAs value team practice and are committed to working in teams with physicians.

As a physician shortage in the state looms, PAs are positioned to be a part of the solution. According to the Bureau of Labor Statistics, the profession is projected to increase 37 percent by 2026 — and that influx of PAs can help to fill the gaps in Nevada’s health care workforce.

The health care needs in rural Nevada are the most significant — only 20 percent of physicians and 30 percent of PAs currently serve in these underserved areas. Despite training that uniquely prepares PAs to care for the diverse needs of this population, PAs are unable to efficiently serve in these areas.

Currently, restrictive laws regarding supervisory agreements with physicians are making it difficult for PAs to work in rural areas. As a result, when physicians are not working in rural Nevada, it is extraordinarily difficult for PAs to work in rural Nevada.

If Nevadans want increased access to high-quality, lower-cost medical care, many things need to change. Modernizing PA practice laws represents a small part of that change, but it could make a huge impact on health care in our state. Now is the time for change — and PAs can handle it.

The need for additional medical providers in Nevada is evident. Lawmakers have responded by increasing the number of medical training programs in the past several years. This includes the approval of the state’s first public university PA program at the UNR School of Medicine.

Last year, PAs celebrated 50 years of service to patients in the United States. Five decades ago, states saw the profession as an efficient and creative way to improve physician shortages and health care access for patients. Early adopters recognized that PAs, who were trained using the fast-track medical training model used for doctors during World War II, were well prepared to care for patients.

Today, PA students continue to be trained under the same rigor and standard of the “medical model,” and in addition to their classroom education, PA students are required to complete 2,000 hours of clinical training before graduating. The background and training of the modern PA student allows PA graduates to be very adaptable and flexible in the health care workforce.

Now more than ever, Nevada needs PAs. They’re filling health care gaps, breaking down barriers and exceeding expectations year after year. Let’s make the most of what PAs can offer.

Julie Thomas is a physician assistant in Reno and president of the Nevada Academy of PAs.

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