Physician assistant Luis Garcia wants to openly share his thoughts on a proposed piece of legislation that he says will transform healthcare access for many.

“Unfortunately, due to the shortage of providers, there are people who are not getting the right care and they're waiting too long to get basic care,” Garcia said.

The bill is a part of Governor Kathy Hochul’s budget proposal but was left out of the legislative budget proposals released Tuesday. It hopes to lift restrictions on how physician assistants, or PAs, practice medicine and allow New Yorkers to get care sooner rather than later.

In 2009, the University at Albany projected that the growth in demand for physicians in the state would outpace the growth in supply by 2030. In 2023, the U.S. Department of Health and Human Services stated that New York needs more than 1,300 physicians to remove designations of health professional shortage areas.

“We know that those rural areas don't have physicians, so that's why PAs can’t practice in those areas, and we have a lot of people who are willing to work in those areas who typically have limited access to health care to begin with,” said Garcia.

There are approximately 20,000 PAs in NY state, who currently are required to be supervised by physicians. The proposal in the governor’s budget will allow some of them to perform several medical services without the supervision of a doctor if they have more than 8,000 clinical hours. It accounts for the training, education and experience that they receive. Another proposal would bring that threshold to a little less than 4,000 hours.

“In certain instances like outpatient, for example, one physician can only supervise four PAs and in hospitals, one physician for every six PAs. Those ratios are old and do not reflect the current practice of most PAs around the state or the country,” said Garcia.

But this isn’t the first time that PAs have pushed for this bill. Last year, the Medical Society of the State of New York, along with several other organizations, pushed back on the bill. They stressed the limitations in education and training that PAs receive, stating that patients deserve care led by the most highly trained professional, which is a physician.

“They're asking for the ability to be independent after 8,000 hours of training. My residency was four years. My training was 16,000 hours. And I probably have, you know, 50,000 hours of experience. So, that is that is something that can't be replaced," said Dr. Paul Pipia, president of the Medical Society of the State of New York.

However, Garcia feels that PAs are qualified and experienced enough to take care of patients without physician supervision and that this could ultimately help with the physician shortage the state is facing.

Garcia added that the proposed legislation, if passed, will bring parity between the physician assistants and nurse practitioners, the latter of whom do not need a physician’s supervision.

“Hospitals may opt to hire nurse practitioners instead of PAs. And nurse practitioners, NPAs, are sort of in the same curriculum, meaning they are thought of as mid-level practitioners,” said Garcia.

MSSNY also shared that it pushed back against that bill as well and still feels that doctor supervision is important for proper care. AAPA hopes there’s a decision on this bill by next month.