Physician assistants in South Carolina will see some of their binds to physicians loosened once a bill receives a final stamp of approval from Gov. Henry McMaster.
Legislation that has passed both chambers of the General Assembly will give so-called PAs more authority to prescribe medication and change how they are supervised by doctors.
The House gave its unanimous approval Tuesday, the last week of this year's legislative session. The proposal only awaits a signature from McMaster, who will "proudly sign it into law when it reaches his desk," a spokesman said.
Chief among the changes: A requirement was lifted so physician assistants no longer have to be located a certain distance from their supervising doctors, and the number of assistants a physician can take on is being doubled.
Advocates said the changes will help keep more health care providers in South Carolina and offer them more freedom to practice.
The law also lets the assistants prescribe up to five days of Schedule II narcotics, the class of drugs that includes opioids. Current law allows physician assistants to prescribe up to three days of the medication.
Jennifer Marshall, president of the S.C. Academy of Physician Assistants, said her organization reached out to doctor's groups late last year. Their support was important.
Patients, especially in rural areas, should notice improved "access to care," Marshall said.
Sen. Tom Davis, R-Beaufort, sponsored the bill. He said the laws in place today are outdated, designed for decades ago, when standards were different.
"They’re not consistent with the level of training that they receive now," Davis said.
Physician assistants will not be authorized to practice independently under the bill, so they will still require a licensed physician to supervise them.
Roughly 1,400 physician assistants are working in South Carolina, according to the U.S. Bureau of Labor Statistics.
Legislation lifting restrictions on health professions are rooted in an effort to improve access to health care across South Carolina, which places 43rd in overall health in America's Health Rankings.
Dr. Todd Schlesinger, president of the S.C. Medical Association, said in a statement that a "useful dialogue" with physician assistants began early in the legislative process.
"This particular compromise expands access to care while also maintaining high quality of care standards," he said.
Groups representing doctors have generally been wary of legislative measures that alleviate restrictions on other health professionals. They advocate that doctors should remain at the top of the health care chain, because of their higher level of education.
This year's legislation takes cues from a law instituted last year that changed how nurse practitioners can practice. In a similar vein, that legislation lifted requirements that nurses needed to be within a certain number of miles of a supervising physician, and increased the number of nurse practitioners a physician can supervise.
Mileage restrictions made more when doctors had to drive to resolve a problem staffers might encounter, Davis said. Physicians today can communicate instantaneously with the nurses and physician assistants.
"This is sort of syncing up the statute with what modern technology allows," Davis said.
Proponents of the legislation also hope it will usher in a new class of physician assistants who might choose to work in South Carolina.
Their ranks may soon increase, given the number of new training programs that have come online in recent years. Just a few years ago, the Medical University of South Carolina had the state's only program. Now, there are five.
The bill allows new physician assistants to begin practicing 10 business days after sending a "scope of practice" agreement, a necessary set of guidelines that lays out the professional relationship with a doctor, to the Board of Medical Examiners.
Chad Robinson, a physician assistant working in surgery at Roper St. Francis, said right now it can take months for board approval. The delay can lead to physician assistants leaving the state for work, he said.
"Unfortunately we’re not retaining as many as we could be, and a lot of it is because of how restrictive the current legislation is," he said.