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HE A LTH • Spring 2020 13 physician. "This particular type of practice and therapy, it does put demands on a practice," McKinnon said. "Lots of physicians don't want to be waivered." What that means in practice is nurse practitioners often want to provide MAT but can't, contributing to a serious lack of resources for people with substance problems, especially in smaller communities. McKinnon said another problem arises when there just aren't enough doctors available to act as supervisors for nurse practitioners. In some behavioral health practices, she said, one psychiatrist can be the official supervisor for 15 or 20 nurse practitioners. In one case on the South Shore, she said, a psychiatrist whose collaborating nurse practitioners serve thousands of patients is planning to retire. The practice has not been able to find a replacement. "Many nurse practitioners will be forced to move their practices to Rhode Island," McKinnon said. "In one state they're qualified to provide this care, and in Massachusetts they can't without a physician." PAs waiting for their turn While the legislation now under consideration at the Massachusetts State House does not include language about physician assistants, Daviau, "We were kind of left in the dust," he said. Pacheco said he supports reforms for physician assistants as well, but in previous years bills addressing both professions haven't made it through the legislature. "That has been seen as too much to ask for as it's gone through the pro- cess in the past," he said. "We figured we would do what most states have done in New England and try to get that on the f loor first." With the bill going through the committee process now, he said he's hoping that vote will come later in the legislative session. collaborative nature of his practice at HealthAlliance, but the legal structure for the profession is outdated. "It does create a burden on hospitals to find supervising physicians," he said. "It's an administrative burden that slows things down and makes it harder to hire PAs within the state." Daviau said MAPA has been disappointed several recent health reform efforts from Gov. Charlie Baker's office have acknowledged the importance of nurse practitioners and dental therapists – who serve a parallel function to NPs and PAs in the dental health field – without addressing PAs. who serves as treasurer of the Massachusetts Association of Physician Assistants, said their situation is somewhat similar to that of nurse practitioners. He said their licenses must be formally appended to a physician's license, even though "for the most part, I'm seeing patients pretty autonomously." When physician assistants first entered the U.S. health care landscape in the 1960s, he said, they were trained in a certificate-level program and worked under direct supervision of physicians. Today, their educational programs are master's or even doctoral level. Daviau said he likes the H In-demand medical professionals The need for physician assistants and nurse practitioners over the next six years is expected to be 20 percentage points higher than general medical doctors. Family and general practitioners 3,469 3,639 4.90% Doctoral or professional degree $218,340 Internists, general 2,783 2,913 4.67% Doctoral or professional degree $246,240 Pediatricians, general 1,700 1,777 4.53% Doctoral or professional degree $198,340 Physician assistants 3,031 3,862 27.42% Master's degree $108,700 Nurse practitioners 6,299 8,031 27.50% Master's degree $122,740 Source: Labor Market Information Occupation Projections, Massachusetts Department of Unemployment Assistance Number Number needed Percent Type of education 2018 average Occupation in 2016 by 2026 change needed for entry annual salary Additional sponsors included: Alera Group | Community Neuroscience Services | Fairlawn Rehabilitation Hospital (an affiliate of Encompass Health) | FLEXcon | The Meadows of Central MA | Commerce Bank, a division of Berkshire Bank | Reliant Medical Group | Robert D. Blute, Jr., Associates in Urology | Vibra Hospital of Western Massachusetts - Central Campus | Webster Five Special thanks to our top sponsors: Media sponsors: @AmericanHeartMA

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