There's a solution to the doctor shortage
“Our next available appointment is in February of next year.”
Sadly, this is a common refrain in doctors' offices today. How many times have you tried to schedule a follow-up or a yearly physical, only to be given an absurd timeline?
That's because we're in the midst of a nationwide physician shortage. The average wait time for a doctor's appointment in cities is 26 days.
Yet getting treated doesn't need to be this difficult. We may have a limited number of doctors, but there's another source of high-quality, professional care. Our hospitals and health care providers need to rely more on physician assistants — who at the moment, are often barred from working at the level for which they're trained. That needs to change.
Physician assistants are licensed medical professionals who handle some routine duties that would otherwise require doctors' time. Their ranks are increasing: in the past decade, the number of board-certified physician assistants grew by more than 75%.
As an emergency room doctor for more than 20 years, I witnessed their rising presence. I experienced, firsthand, how incredibly useful and even crucial physician assistants can be; they handled duties like suturing and treating minor injuries, freeing me up to focus on more complex cases.
This essential work takes some responsibility off doctors' plates and allows more patients to be treated sooner. But in many states, physician assistants aren't allowed to practice to the full extent of their training — at the “top of their license” in industry speak. That means that even a physician assistant who had performed a procedure thousands of times would be prohibited from doing so.
Unfortunately, these limits exist in large part because doctors insist on them. Groups representing physicians are fighting legal changes that would expand the duties physician assistants may perform — known as their “scope of practice.”
This could result in tragedy in medically underserved areas of the country like Mississippi, where bills to expand scope of practice were defeated last year. The Magnolia state has one of the worst physician-to-patient ratios in the country, with fewer than 200 doctors per 100,000 people. The number of certified physician assistants in the state increased by nearly half between 2018 and 2022.
Doctors who oppose expanding the scope of practice for other health care professionals say they're worried about patient safety. But physician assistants have completed two- or three-year master's degrees that include medical coursework and clinical rotations.
The real reason some doctors oppose scope expansions seems to be financially motivated. Because of insurance company rules, practices typically see less reimbursement for work done by physician assistants. Yet doctors worried about diminishing financial returns are perceiving a scarcity that doesn't exist: there's no shortage of patients.
Neither observation nor research supports the notion that expanding scope of practice for physician assistants will hurt patients. And a study performed by Health Services Research found that primary care patients who see nurse practitioners have similar health outcomes compared to patients who see physicians.
For sure, it's tough to see a doctor. But physician assistants are helping patients every day. Let's ensure they are able to continue doing so.
Nicole Wadsworth, D.O., FACOEP, FACEP, is dean of New York Institute of Technology's College of Osteopathic Medicine, which has locations in Long Island, N.Y., and Jonesboro, AR. This piece originally ran in Salon.