Oklahoma PAs: State of the State Address - Allison Garrison, PA-C OAPA Leadership and Advocacy Liaison
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Oklahoma PAs: State of the State Address Allison Garrison, PA-C OAPA Leadership and Advocacy Liaison September 29, 2021
Let’s Take a Look
01. How Do We 02. Why Do We
Assess The Care?
Situation?
1. Employment
1. A look at our history.
2. Equality
2. Comparing states.
3. Change in standards of
3. Comparing competitors. practice, access to care
03. What Do We Do 04. What’s next 05. Educate
With The
Information? 1. Fundraising 1. Educate PAs, other
1. Assess need for change. health professionals, and
2. Involvement possibly the public of any
2. Plan. 3. Proactive change changes.
2 State of the State 2021
Assessing the
Situation
Looking back:
-Oklahoma used to be top in the U.S. for scope for PAs
-New grads often had multiple jobs to choose from
-Students and practicing PAs involved
Comparing to other states:
-Oklahoma now has fewer OTP and other scope allowances
than most other states despite recent legislation.
Comparing to competitors:
-PAs are number 1! ??
-NPs have more scope in most states despite less
education.
-NPs are employed over PAs for the same position more and
more often, including in Oklahoma. Why?
3 State of the State 2021 This Photo by Unknown Author is licensed under CC BY
Why Do We Care?
Access to jobs
-barriers from scope or red tape
-competitors are doing the hiring
-lack of PR
Access to care
-barriers from scope
-practice changes from federal
standards/time/situations (covid)
-telehealth, rural med, socioeconomics, race,
etc
4 State of the State 2021
5 Annual Review September 27, 2021
Comparing Oklahoma
Physician/PA Ratio Supervision
Language
Oklahoma 1:6 ratio – In Oklahoma Delegating
Question (2020) with combo of
sup/collab/deleg
31 states have NO ratio or
exceptions 21 states have moved away from
supervision to collaboration (In
2019 it was 11); (6 FPA)
Schedule IIs PA Board/PAs on Other issues??
Med Board
Oklahoma newly recognized Oklahoma NO We need to hear from YOU
but still a work in progress
30 states have their own PA
Only 3 states fully restricted Board or at least 1 PA on
the Medical Board
Only 4 states no outpatient
6 State of the State 2021
“
The difference between the almost right
word and the right word is really a large
matter.
Mark Twain
Words that Matter
Supervision Delegate Collaborate Must vs. May
Generally means to be The act of giving another The process of two or more Must: the only word that
physically present or within person the responsibility of people, entities or imposes a legal obligation
immediate distance carrying out the organizations working that something is mandatory.
performance agreed in a together to complete a task
contract or achieve a goal. May: is an expression of
possibility, a permissive
choice to act or not, and
8 State of the State 2021 ordinarily implies some
degree of discretion.
Deeper Into The Issues Ratio Issue MEDICAL DOCTOR 11,880 6,724 (2021 OBMLS) ▪ SB 1915 passed in 2020 intending to remove ratios Physician Assistant 1,975 1,740 (2021 OBMLS) ▪ Medical Board unanimously passed emergency rules Osteopathic Physicians 3,153 2,543 (2019 OSBOE) 9/10/20 to eliminate ratios to comply with SB1915 but never sent to governor APRNs 5,217 4,110rx (FY20 NB) ▪ Covid rules expired during Summer 2021, Medical Board went back to old 1:6 ratio despite never retracting other rules or promulgating new ones ▪ SB 516 to clarify ratio was stalled out by physician associations claiming independent practice ▪ AG opinion in process, possible FTC action 9 State of the State 2021
The Physician Gap
Shortage Info It’s Already Here
• The most recent projections from the American
Association of Medical Colleges (AAMC) in June of
2020 show that the United States could see a “THERE’S AN EXTREME SHORTAGE. OKLAHOMA IS
shortage of between 54,100 and 139,000 ONE OF THE DESERTS FOR PHYSICIANS IN THE
physicians by 2033. This would include shortfalls in
both primary and specialty care. UNITED STATES,” SAID LARRY BOOKMAN, MD,
PRESIDENT OF THE OKLAHOMA STATE MEDICAL
• Population increase
ASSOCIATION. -APRIL 15, 2020
• Aging Population
• Retiring Physicians on the rise
• 5 times more in rural areas
11 State of the State 2021MD Board: 7 allopathic physicians + 4 lay members
• Physician terms 7 years, appointed by Gov from list by OSMA
• Lay members appointed by Governor and serve along his/her term
PA Advisory Committee: 2 PAs (appt by Med Board from list
from OAPA) + 2 MDs + 2 DOs + each PA Director (non-voting)
• Only advisory to Medical Board, meet separately
Nursing Board: 11 members appointed by the Gov.
• 9 nurses and 2 lay
• 2 are APRNs
12
2021
State of The StateSchedule IIs
2014 2020
Hydrocodone changes to OAPA begins seeking legal
schedule III by DEA advice on authority as more
PAs express barrier to care
in Peds, hospice, ER, rural
med, etc
2018 2021
CDC and other authorities OBNDD released
begin making best practice “onsite/ongoing”
guidelines for opioids in administration to comply
response to opioid epidemic with law. MD and DO
Boards agree. Pharmacy
Board asks for help with
13 State of the State 2021
PBMs.Safety Data (2020) 14 State of the State 2021
Our Legislative Team Allison Garrison, PA-C Jan Loftis Tyler Powell Matt Latham Leadership and Advocacy OAPA Lobbyist OAPA Lobbyist OAPA Lobbyist Liaison 15 State of the State 2021
What’s Next?
Fundraising Involvement of Membership Public Relations
▪ PAPAC ▪ What members want/need ▪ Public support of issues
▪ OAPA general funds ▪ Grassroots efforts • Legislator support, etc
▪ Healthy association ▪ Transition with changes
▪ PAs/students in advocacy at ▪ Protection from smear
every level campaigns/efforts
▪ PAs needed in administration
16 State of the State 2021Summary The PA profession is lagging behind in Involvement is necessary Oklahoma compared to other states PAs can be part of the physician shortage Change is inevitable-for better or worse solution if barriers are removed Funding is necessary 17 State of the State 2021
Thank you
The best way to predict the future is to create it.
-Abraham Lincoln
Allisongarrisonoapa@gmail.comYou can also read
