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PAs at Alabama's Table to Fix Broken Healthcare System


PAs have always taken a team approach to medicine. That focus is applicable to policy issues as well as clinical ones.

I have always said that, "If you are not at the table, you are what's for dinner."

PAs need to be involved in the administration of hospitals, facilities, and any bureaucracies that make health policy decisions. Really, anyone who works on the front lines of providing healthcare has a unique perspective that would help to inform the decision making on health policy.

The most recent example of a PA taking a high-level role in health policy is Stephanie McGilvray, PA-C, past president of the Alabama Society of Physician Assistants and assistant professor at the University of Alabama-Birmingham School of Health Professions. She was appointed by the Governor of Alabama via executive order to serve on the Alabama Healthcare Improvement Task Force. This task force has the "simple" job of recommending to the governor ways in which to improve human resources and access to care for all Alabama residents.

McGilvray and the physicians, NPs, pharmacists, industry representatives, consumers, and others on the committee have the unenviable task of looking at healthcare in a state with some of the most dire healthcare statistics in the country.

Alabama ranks among the bottom states when it comes to vital health statistics in the U.S. More than 20 percent of the population between the ages of 18 and 64 are without health insurance. The state ranks high in deaths caused by cancer and cardiovascular diseases and has large populations of diabetic and obese patients. Adding to the access to care issues, there have been multiple hospital closings in the state, and the recruitment and training of physicians and other healthcare providers remains challenging in rural areas.

I'm really glad that the task force, like much of healthcare, is taking a team-based approach to finding ways to improve care and relying on physicians, PAs, and other care providers to find solutions to Alabama's healthcare problems. There are no easy fixes, but having a variety of perspectives and experience on that team should be a good start.

PAs have been serving the most vulnerable populations in states such as Alabama in teams with physicians for many decades. There are over 500 PAs currently practicing in Alabama, along with more than 5,000 primary-care physicians and 5,700 specialty physicians. Like many states, Alabama has difficulty recruiting and retaining physicians, PAs, and other healthcare professionals to rural and medically underserved areas. The same trends and pressures experienced by physicians are mirrored in PA practice and deployment.

Recently, PAs and NPs were shown to have a positive impact in Alabama's healthcare access issues. A recent cost analysis in Nursing Economic$ found that even modest changes to Alabama's restrictive PA and NP laws would result in a net savings of $729 million over a 10-year period.

I am hopeful that the members of this task force can come up with recommendations that are put to work to change the health and well-being of all Alabamians. I'm confident that the PA input into this process will be valuable and productive. The more than 100,000 PAs in the U.S. have a unique insight into healthcare delivery in this country, as well the academic training and experience to contribute more than just healthcare delivery to the communities in which they live and to the patients who depend on them for healthcare.

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