A group of bills passed this session would expand how physician assistants can operate in the State of New York. It's part of a broader push by PAs this legislative session to increase their autonomy, but not all of those efforts were successful. 

Edward Mathes, president of the New York State Society of Physician Assistants, said there was much to celebrate within the package. 

He said the most important aspect is a bill to increase physician-to-PA ratios, allowing physicians to supervise no more than six physician assistants in a private practice at one time.

Mathes said the addition of "at one time" language is important because previously, even if a PA was absent, it was difficult for physicians to bring in a replacement temporarily.

“If a PA goes on vacation or is out on some sort of sick leave; that practice is short one person; if they’re maxed out on the number of physicians a person can supervise; with the 'at one time' provision, they can hire somebody to fill in,” Mathes said.

Also passed was a bill that would allow PAs to serve as primary care practitioners for purposes of Medicaid managed care plans, along with expanding other responsibilities.

“It will increase access and benefit patients in the long run,” Mathes said.

An effort to eliminate supervision requirements for PAs working in primary care medicine and some other non-surgical specialties with 8,000 clinical hours was unsuccessful.

“The care PAs provide is equivalent to that provided by physicians; the quality of care is there,” Mathes said in response to criticism that PAs have lesser training than physicians. 

The Medical Society of the State of New York said it is neither opposing nor supporting the bill to adjust the ratio and add an "at one time" provision.

“The reason we're not actively opposing it is because it still allows for physician oversight. The Medical Society believes that physicians are the experts in medical care,” said David Jakubowicz, president-elect of The Medical Society of the State of New York.

That’s why, he said, the Medical Society does oppose the additional step of further eliminating those supervision requirements. 

“Ultimately, the physician needs to be the one who is charge of the team covering the care. Truthfully, most patients would prefer to see a physician from the onset in order to get the management of the patient's care,” he said.