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Physician Assistant Bill Clears First Hurdle

The Senate Committee on Business and Professions approved SB 352 by Sen. Fran Pavley (D-Agoura Hills), a bill designed to allow physician assistants and other providers to oversee work by medical assistants.

“MA’s are only allowed to do basic medical tasks, but if a physician’s not there on-site, then the MA can only do clerical work,” Pavley said. “Under this bill, a nurse practitioner, midwife or physician assistant can supervise them, without a physician being on the premises.”

Pavley made it a point to say the bill doesn’t change what medical assistants are allowed to do, or even what physician assistants or nurse practitioners are allowed to do.

“This isn’t changing scope of practice,” she said. “This bill simply expands the settings for what they’re already allowed to do, freeing up other staff to tackle other tasks.”

There are 82,000 medical assistants in California, Pavley said, and that number will likely increase as the demand for primary care services booms under the Affordable Care Act. Those medical assistants will need to assist, Pavley said, not just do paperwork.

Stephanie Roberson, legislative advocate for the California Nurses Association, disagreed. The nurses union opposes the move on several grounds.

“We appreciate the intent of this, but we think it will contribute to fragmentation of care,” Roberson said, by creating incentives to use MA’s more.

“Bottom line,” she said, “this is MA’s being used on the front lines of health care, and we would like to see qualified licensed providers be on the front lines.”

Roberson also was concerned the legislation would encourage supervising providers to issue standing orders in a patient’s chart that would then be carried out by MA’s.

Pavley said she would consider amendments to address the latter point, but that letting medical assistants help in the ways they’re trained to help just can’t be a bad idea.

SB 352 doesn’t expand what MA’s can or can’t do,” Pavley said. “Doctors are stretched thin, so if the PA or NP is on-site and the doctor has to leave, … the medical assistants can continue to do what they do. Otherwise, they would have to stop and do clerical work. It’s not really a scope of practice bill at all.”

The bill passed the business and professions committee on a 9-1 vote and now heads to the Senate Committee on Appropriations.

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