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  • Introduced by: Craig Backs, MD, Delegate, Sangamon County Medical Society

    Subject: Physicians-to-PAs Ratio

    Referred to: Reference Committee C

    Whereas, many rural and underserved areas in Illinois are experiencing physician shortages that negatively affect patient access to care; and 

    Whereas, many physicians establish collaborative agreements with PAs in order to maximize the services and care a medical practice is able to offer to patients in the community; and

    Whereas, current ISMS policy supports allowing a physician to establish collaborative relationships with a maximum of only five PAs; and

    Whereas, the 1:5 physician-to-PA ratio significantly limits opportunities for physicians who wish to enter into additional collaborations that could expand and enhance patient care; and

    Whereas, in some rural areas there are not enough physicians to sustain a 1:5 ratio of physicians-to-PAs, which undermines the ability of physicians and PAs to work collaboratively to expand access to care in these areas; and

    Whereas, hospitals are exempt from the current statutory 1:5 physician-to-PA ratio, while physician clinics are not; therefore, be it

    RESOLVED, that ISMS support eliminating the physician-to-PA ratio requirements currently governing collaboration between physicians and PAs in Illinois.  

    Existing ISMS policy related to this issue:

    ISMS supports that physicians may supervise and/or have collaborative agreements with no more than five full-time, mid-level providers (Physician Assistants, Advanced Practice Nurses), and in doing so should carefully consider a multitude of factors that will influence their ability to adequately supervise and/or collaborate, including geographic location, scope of the physician’s practice, complexity of patient populations, volume, and experience and/or training of the physician must be taken into account. (HOD 2012)

    Board of Trustees approved ISMS support for changing “supervision” to “collaboration” under the Physician Assistant Practice Act of 1987 and directed that the essentials of the physician/physician assistant relationship be reflected in a written practice agreement between the physician assistant and a physician; that prescriptive authority continue to be delegated by the physician; that the ratio of five PAs or APNs to one physician be maintained; and that the prohibition of physician assistants’ billing for services individually be maintained. (BOT 2016 - OCT)

    Board of Trustees approved that ISMS continue to work with the Illinois Association of Physician Assistants on IAPA’s proposed changes to the Illinois Physician Assistant Practice Act, but oppose language that would grant PAs independent practice; work to ensure the ratios are maintained as well as the delegation of prescriptive authority; and reject efforts to allow PAs to enter into a medical corporation. (BOT 2017 - JAN)

    Board of Trustees approved that ISMS uphold its policy and oppose removing the physician assistant/physician ratio, oppose efforts to allow PAs to bill directly for their services and to remain neutral on the issue of certification. (BOT 2017 -APR)

    Board of Trustees approved that the ISMS not change the 1:5 ratio of physician to PAs. (BOT - JAN 2018)


  • The commenting period is now over.
    Comment List
    Larry M. Sapetti, M.D. I favor this resolution

    I support removing the current physician to PA ratio 

    This should be an individual physician decision

    Apr 12, 2018 at 7:58 a.m.

    Mark McKay I favor this resolution

    Mark McKay MD wholeheartedly supports this resolution

    It is a no brainer!!

    Apr 13, 2018 at 6:35 p.m.

    Janet Albers I favor this resolution

    I support removing the ratio. 

    Apr 14, 2018 at 11:41 p.m.

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