Newton doctor wants lawmakers to look closely at physician assistants bill

Dr. Patrick Edwards of the Newton Clinic pleaded with local legislators on March 18 to vote against House File 424, which he suggests would lower the standards of providing medical services to Iowans by allowing the practice of physician assistants without supervision by a physician.

The bill has already passed in the Iowa House. During a legislative gathering at the Newton Public Library, Edwards strongly recommended his local lawmakers take a second look at the bill, reasoning the amount of training a physician needs to prescribe medicine is considerably more than a physician assistant.

Edwards said he underwent four years of undergraduate work and seven years of extensive medical training: four years of medical school and three additional years of training. Physician assistants require less training with only four years of undergraduate studies and two years of additional medical training.

“So that’s compared to seven years of fairly extensive training that I received in order to prescribe medications,” Edwards said. “Up until now, the physician assistants are authorized to work under direct supervision of physicians in collaboration. All of their work is monitored and directly supervised.”

If passed by the Iowa Senate and signed into law by the governor, physician assistants would no longer need to be supervised by another doctor. The bill, according to Edwards, said physician assistants can work in collaboration with the doctor but not under supervision.

“Collaboration is not defined, and that raises concerns,” Edwards said to lawmakers. “Again, I respect the physician assistants, but I’m not sure that two years of training is adequate to let them go into the community, hang out their shingle and prescribe medications with no supervision.”

There are also liability concerns. If an assistant is working under a doctor and something bad happens, Edwards questioned who takes the responsibility.

Ultimately, Edwards opposes the bill and thinks it would be a bad idea.

“I know you guys aren’t on this committee (health and human services), but I would encourage you to look at that closely,” Dunwell said.

Rep. Jon Dunwell, R-Newton, voted against it on March 7. Despite his opposition, the bill passed the House in a 90-8 vote. Dunwell said his concerns were similar to Edwards’ and he needed more information to understand the roles of the physician, physician assistant and nurse practitioner.

Sen. KenRozenboom admitted he had not spent much time on the bill. Dunwell said Edwards’ testimony would be helpful in helping legislators understand the differences in training and the differences between physician assistant and nurse practitioner, the latter of which requires more training.

“I think legislators need to understand that better. I think their focus right now (is) we need more medical coverage out there, so this looks like a quick solution.,” Dunwell said before turning to Rozenboom. “On the Senate side, I would encourage you to bring more information on that.”

Rozenboom added, “To the greater point here, obviously several things we’ve done deal with the shortage or the concerns about shortages of medical services in rural Iowa. It’s increasingly becoming a problem … I appreciate your comments. I respect your training and your experience and your views.”

In the state’s pursuit of filling open jobs, Dunwell said “there has to be a balance between getting that job filled or that need filled” and making sure Iowa is not lowering its standards and causing problems. Edwards agreed, saying Iowa needs quality education and quality health care.