An Open Letter to PR’s Politicians: Advocating for Change
Honorable Party Member,
Greetings. I am writing to you on behalf of the Academy of Physician Associates of Puerto Rico to express the vital importance of certified physician associates (PA-Cs) in delivering healthcare services on our island as an option to extend access to healthcare and mitigate the debilitating effect of the exodus of thousands of licensed physicians from the island over the past decade. Below, I will detail who we are, how we can contribute to Puerto Rico's healthcare system, and how we differ from the practice of physician assistants currently existing on the Island under Law 71 of 2017. Our goal is to include PA-Cs certified by the National Commission on Certification of Physician Assistants (NCCPA), whose education was stipulated by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), as part of the political agenda for healthcare reforms. We see this as an effective solution to increase access to high-quality medical services for Puerto Ricans, especially in rural and underserved areas, thereby relieving the growing and overwhelming burden on licensed physicians on the Island.
Who are we, and how have we contributed to the healthcare system?
Physician associates (PA-Cs) are highly trained, licensed professionals who care for patients in collaboration with an interprofessional healthcare team, including licensed physicians, where the licensed physician continues to serve as the leader of the healthcare team. From primary care and emergency rooms to surgical subspecialties, physician associates are capable and trained to:
Evaluate, diagnose, manage, and provide medical and surgical treatments, including treatment plans.
Order, perform, and interpret diagnostic studies and therapeutic procedures.
Educate patients on health promotion and disease prevention.
Provide consultations at the request of patients.
Draft medical and surgical orders, including obtaining informed consent by delegation.
Provide parking permits for individuals with disabilities.
Declare deaths and complete death certificates.
This model has not only proven successful in all 50 states of the nation and around the world, but it also represents an opportunity to significantly improve access to healthcare on the Island in an efficient, accessible, and equitable manner. Additionally, this profession is cost-effective, with the potential to generate greater revenue for the Island’s healthcare system while reducing costs by preventing complications and hospitalizations that result from a lack of access to basic services.
How do we differ from médicos asistentes under Law 71?
In 2017, Law 71 was enacted to regulate the profession of physician assistants in Puerto Rico. This law was created in response to the need for doctors, generating a local version of a profession that has existed in the United States since the 1960s. However, this local version includes two types of healthcare professionals with different educations and missions under the same title (PA): certified physician associates and physician assistants, who are mostly graduates of international medical programs that have not passed their medical boards.
This has caused great confusion at governmental, political, healthcare, and community levels about our training and capabilities. It has also created disadvantages for physician associates seeking employment on the island due to a lack of knowledge about our credentials and training, leading many of us to migrate to the mainland United States in search of better opportunities to fully practice our profession. Furthermore, the improper use of the PA title by other groups can undermine the value and specialized training of PA-Cs, which is counterproductive to the goals of improving access to and the quality of medical care on the Island.
Take Away
Physician associates do not wish to minimize or displace physician assistants from their current position. On the contrary, our goal is to differentiate the profession of physician associates from that of physician assistants, educating the healthcare system and the community on how we are a high-quality and cost-effective solution for the healthcare system, increasing compensation and reimbursement for both physician associates and licensed physicians, as is done in the United States. To achieve this, we respectfully urge that your platform and work plan support the review of Law 71 and create fair legislation for physician associates, helping to protect our PA-C title, which we have carried with honor for over 60 years.
On behalf of the Academy of Physician Associates of Puerto Rico, we thank you for your attention to this matter of utmost importance for the well-being of our population. We are at your disposal for any additional inquiries or to coordinate meetings where we can discuss this issue in more detail.
Sincerely,
