States modernize PA practice laws to expand healthcare workforces

May 1, 2026 - 03:18

Three states have recently passed laws modernizing how physician assistants (PAs) can practice, aiming to quickly fill gaps in rural healthcare. Kentucky, South Dakota, and Iowa have all updated their regulations to remove outdated supervision requirements, allowing PAs to work more independently. Supporters say these changes will speed up patient access to care in underserved areas where doctors are scarce.

The new laws typically shift away from requiring a direct, on-site physician for every PA. Instead, they allow for broader collaborative agreements or looser oversight. This lets PAs handle more routine visits, prescribe medications, and manage chronic conditions without a doctor physically present. Proponents argue this is a common-sense fix for states where patients often drive hours for basic care.

However, the changes have sparked pushback from some physician groups. Doctors in these states have raised patient safety concerns, warning that reducing supervision could lead to missed diagnoses or improper treatment. They argue that PAs, while highly trained, do not have the same depth of medical education as physicians. Critics also worry the laws were passed too quickly without enough input from practicing doctors.

State officials counter that the modernization is carefully structured. They point to decades of safe PA practice in other states with similar laws. For now, Kentucky, South Dakota, and Iowa are betting that cutting red tape will help their healthcare workforces keep up with demand, especially in rural counties that have struggled to recruit and retain doctors for years.