February 28, 2017

Full Practice Authority and Responsibility Survey Report released 

According to new data, almost three-quarters of PAs (72 percent) who responded to a survey express support for the full practice authority and responsibility (FPAR) proposal drafted by the Joint Task Force on the Future of PA Practice Authority.

Issued in December 2016, the proposal includes four components for the profession on which the Joint Task Force was seeking comment: Team-Based Practice; Elimination of Supervisory Agreement Requirements in Law/Regulation; Creation of Autonomous State PA Boards; and PA Eligibility for Direct Reimbursement.

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Methodology

AAPA conducted the FPAR survey from Jan. 12, 2017, to Feb. 1, 2017, emailing it to more than 100,000 PAs, retired PAs, and PA students; 12.6 percent responded (12,285 people). The margin of error is +/- 0.83 percent at a 95 percent confidence level.

Survey results at a glance

Full results of the survey can be found here along with a compilation of responses to open-ended survey questions.

Overall, 72 percent of respondents said they supported the Joint Task Force proposal as a whole, with 13 percent expressing opposition and 16 percent saying they have not yet made up their mind.

When asked about each of the four components separately, almost all PAs said they support Team-Based Practice (96 percent) and PA Eligibility for Direct Reimbursement (93 percent).

Nearly 80 percent of PAs said they support Creation of Autonomous State Boards, which would be comprised of a majority of PAs, to license, regulate and discipline PAs. (Only 7 percent oppose; 14 percent are not sure yet.)

Support for the Elimination of Supervisory Agreements in Law/Regulation was slightly lower, but still strong at 63 percent, with only 20 percent opposing it. The rest of respondents are not sure (17 percent).

This data points to a strong and statistically significant correlation between a PA’s support for eliminating laws that require supervisory agreements and a PA’s personal experience of NPs getting hired over them due to PA supervisory requirements.

Almost half (45 percent) of the PAs that responded to the survey reported that they have personally experienced NPs being hired over PAs due to supervision requirements.

Those PAs who have personally experienced NPs being hired over PAs because of the supervision requirement were almost twice as likely (71 percent vs. 39 percent) to agree that state law should not require PAs to have a specific identified relationship with a physician in order to practice, compared to those who had not had that experience.

It is worth noting that some factors did not make a statistically significant difference in respondents’ support for the elimination of laws that require PAs to have supervisory agreements, including whether a PA practice in primary care or a different specialty and whether NPs already have full practice authority in the respondent’s state. Years of experience as a PA was not associated with large differences in support or opposition to the elimination of supervisory agreement requirements, although late-career PAs were slightly more likely than students or other PAs to say they support it. Students were least likely to oppose elimination of supervisory agreements and most likely to say they had not formed an opinion. Similarly, the number of Key Elements of a Modern PA Practice Act that had been enacted in a PA’s state had very little effect on their view about eliminating the supervisory requirement, with 58 percent expressing support in states with 1-2 or 5-6 Key Elements, and 60 percent expressing support in states with 3-4 Key Elements.

Next steps

The Joint Task Force will consider all of the PA feedback received over the past four months, including the survey results, revise the proposal, and bring forward a resolution to AAPA’s House of Delegates (HOD). The revised proposal regarding PA practice authority will be considered by the HOD at its May meeting during AAPA Conference 2017 in Las Vegas.

For questions about the survey or about FPAR, please email: fparfeedback@aapa.org.