Healthcare workforce reform aims to better serve patients

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A new North Carolina law commits the state to a physician assistant licensing compact and eliminates supervisory requirements. The new rules are expected to to improve patient access to PAs and allow them to develop their ranks.

A new North Carolina law aims to improve patients’ access to adequate health care.

Gov. Josh Stein signed House Bill 67 on July 1, which commits the state’s entry into the physician assistant licensure compact and removes outdated supervisory requirements. 

“Today marks the start of the 2025-26 AAPA leadership year, and it is thrilling to also mark today as a history-making day for PAs as we celebrate a landmark legislative victory in North Carolina – the state where our profession was founded,” AAPA President and board chair Todd Pickard said. “With the enactment of this law, more than 9,000 PAs in North Carolina will be empowered to improve healthcare in the state. PAs are essential to expanding patient access to high-quality care — this was true in 1967 when the first class of PAs graduated from Duke University Medical Center, and it is true today.” 

Truett Smith, a Charlotte-based PA, offered insight on what this law will do to improve healthcare access.

“There's several parts of House Bill 67… one part that helps PAs is that it will establish a career entry level of the first 4,000 hours of their career,” Smith said. “The first two years, they’re kind of in a team-based setting, but they’re also going to be under supervision of a physician. Then, after that 4,000 hours, they'll be … specifically under their own license. They won’t have to be connected to a supervising physician at that point.”

The Team-Based Practice Act, according to the North Carolina Academy of Physician Assistants, will eliminate requirements for experienced PAs to have a specific relationship with a doctor when working in a team-based setting. This change gives flexibility to healthcare teams to be able to address healthcare challenges where they are needed most. It also makes sure PAs can work to the fullest extent of their training, education and experience.

The PA Compact allows PAs to provide care across state lines, which has the potential to help underserved and rural areas.

“There’s going to be multiple compact states, say, if South Carolina is involved, if Virginia is involved,” Smith said. “So, all our adjacent states, when we go to apply for a medical license, we would have the opportunity to also apply for a license in those other states. And now, with virtual medicine, it makes it much, much easier. You don’t have to go through all these different application processes… so you can actually take care of patients and other communities in other states, and also, if you were a provider in Virginia, you could take care of our patients in rural North Carolina and the mountains. So, it really does offer much more access opportunities for our patients.”

Smith said the law will likely help with improving manpower within the medical field as well. 

“If you modernize PA law, we expect this to have an immediate impact on the workforce in North Carolina,” he said, “because we currently have 12 different PA schools that train PAs, but many of those PAs, once they’re trained, they go to other places. Maybe they have better laws for PAs, but if you modernize the PA laws, we hope to immediately retain more PAs here, as well as have people moved to our state because they realize that this is the best place for a PA to practice, so that should improve immediately. Then we expect there to be a 28% growth in PA employment just over the next 10 years.”

Smith said he couldn’t forecast how many more patients could be helped, but HB 67 will help alleviate the shortage of medical workers, which he feels also correlates to more patients being helped in the long term.

“There’s data that shows there'll be a shortage of up to 3.2 million healthcare workers by 2026, so that’s just the huge need of primary care providers and providers in total. … But there are 4,000 people that are moving to the Charlotte area where I practice every week. So, you can imagine we’ve already got a shortage, we already have an access problem, and it's just going to get harder and harder to have enough providers to see the patient.

“We really expect an immediate effect because of this new law.”

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