Improve access to health care for Hispanics and rural America

After being dropped off at my bus stop, I walked home – feeling my anxiety levels rising with every step toward my mobile home. It was 1996 in my poor, rural hometown of Salem, New Mexico, and the usual presence of my parents was eerily absent. My gut instinct was right; no one was home. I sat on the wooden stoop waiting for my parents to come home. After all, I was just in the third grade – I hadn’t been entrusted with keys to the house.

In the distance, I saw my godmother walking from her home towards me. She gave me a hug and ushered me to her home to wait for my parents’ return. Earlier that day, my father experienced a stroke and fell on the cement patio of my godmother’s home.

The nearest stroke center was 85 miles away. He was rushed by ambulance to a nearby town, where he was then transported by helicopter to a trauma center in Texas. He had undetected atrial fibrillation. My father rarely sought medical care, and he was not aware of the benefits of wellness exams.

He survived that experience; however, he wouldn’t be as lucky next time.

A decade later, he was tragically struck by a car and succumbed to the injuries he sustained after delayed transportation to the nearest trauma center. It is difficult not to believe he might still be around if accessing health care wasn’t such a challenge.

Like 41% of Hispanic citizens in this country, my parents lacked healthcare literacy. The experiences I lived through with my father cemented in me the realities of the healthcare disparities that Hispanic and rural communities face in this country every day.

Of those living in rural America, 25% reported having troubles with accessing health care. Experiencing these disparities was my motivation for becoming a physician associate/assistant (PA). I wanted to make sure I could come back and serve my community in the way my dad had deserved.

At a time when healthcare workforce shortages are steadily increasing, I am proud to be in a medical profession that is continuing to grow. PAs are part of the solution to bridging the gap in Hispanic health literacy and accessibility to health care in rural America.

PA students’ demographics drive their interest in practicing in medically underserved areas (MUAs) after graduation. Since completing my training, I have served Hispanic communities in MUAs, as I promised myself I would. PA programs across the country must continue to seek applicants who maintain professional goals that align with an MUA-driven mission.

Unfortunately, administrative requirements for PAs are burdensome for healthcare systems and patients. For example, most states require PAs to have a specific relationship with a physician to practice. This requirement does not align with the way health care is delivered to patients today. In today’s healthcare environment, we need flexibility to provide quality health care to all patients, no matter where they may live.

The legal tether requiring a PA to have a specific relationship with a physician puts an unnecessary strain on the healthcare system, especially in Hispanic and rural communities.

Within our profession, we often hear stories about PAs who have been rendered unable to care for their patients after a sudden change in the legal status of their supervising physician. For example, a few years ago I read about a Wyoming PA who  was no longer able to serve his patients after his supervising physician passed away in her sleep. The PA was the only healthcare provider in over 1,800 square miles and was responsible for serving a community of 2,200 people. Following the physician’s death, he was no longer able to serve his patients – not because he wasn’t trained and qualified to do so but because of an outdated law.

Fortunately, in 2021 Wyoming Gov. Mark Gordon signed legislation that repeals requirements for PAs to have a specific relationship with a physician or other provider in order to practice. But the majority of states, including my home state of Arizona, still need to make this change. Working in a group with only one supervising physician, I worry that the patients I care for could one day be in the same situation.

Continuing to leave unnecessarily restrictive laws in place only perpetuates the same failures in the healthcare system that my father had to endure. We owe him and those like him much more than that.