Law 71 and Florida’s PA ACN Policy: Addressing Shortages or Undermining Standards?

Recent developments surrounding the use of Puerto Rico Médicos Asistentes licenses have raised critical questions about how these credentials are being leveraged to fill gaps in physician care—both on the island and in the mainland United States. Médicos Asistentes, who are international medical graduates who do not qualify to sit for the PANCE (Physician Assistant National Certifying Exam), are not equivalent to state-side PAs. Despite this, individuals holding a Médicos Asistentes license have been able to apply for licensure under Arizona’s universal license recognition policy. However, the Arizona initiative did not align with the professional standards expected of PAs nationwide, leading to a recall of applications submitted by Puerto Rico Médicos Asistentes.

Law 71 in Puerto Rico originally sought to expand healthcare access by allowing Médicos Asistentes to function under a “PA-like” scope of practice, aiming to address provider shortages. However, this approach has inadvertently created pathways for individuals to bypass stringent PA certification requirements. Similarly, Florida’s PA Critical Need Area (ACN) law now permits easier licensure for PAs in areas with healthcare shortages. Concerns are growing that this law enables Puerto Rico médicos asistentes to gain Florida licensure despite their lack of equivalency to U.S.-trained and certified PAs.

While these laws aim to reduce procedural burdens and expand access, they risk undermining the PA profession’s integrity by allowing individuals with lesser regulatory standards to practice. The migration of Puerto Rico’s Médicos Asistentes to Florida—using either their Puerto Rico license or Arizona’s now-recalled license—illustrates how these policies can have unintended consequences. It remains unclear why Florida is proceeding with such measures despite evidence from Arizona’s experience. Could this further dilute the high standards that define the PA profession nationwide?

Take Away

As policymakers move forward, careful scrutiny is essential to ensure that efforts to expand access do not come at the expense of professional standards, patient safety, or the integrity of the PA profession nationwide.

As these developments unfold, we remain committed to keeping our members informed and advocating for policies that prioritize quality care while preserving the credibility of the PA profession. If you have concerns or would like to share your thoughts, please reach out to us