MSSNY PULSE

Colleagues:

As New York policymakers continue discussions surrounding the state budget and broader health care policy, one principle should remain central to every proposal: protecting patients by preserving physician-led care.

Patient care depends on a team of dedicated professionals. Physician assistants, nurse practitioners, pharmacists, nurses, and many other health professionals play vital and valued roles in caring for patients across New York. Physicians work closely with these colleagues every day, and their contributions are essential to the delivery of high-quality care.

At the same time, physicians bring a unique level of education and clinical training to the care of patients. Physicians complete four years of medical school followed by several years of residency training—often totaling more than 10,000 hours of supervised clinical experience before practicing independently. This extensive training prepares physicians to diagnose complex conditions, manage complications, and coordinate care across multiple specialties.

The physician’s role in overseeing and coordinating patient care remains a critical safeguard within our healthcare system.

The Executive Budget includes proposals that would permit many physician assistants to practice without physician supervision or collaboration after 8,000 clinical hours. While physician assistants are highly valued members of the healthcare team, completely removing the important role physicians play in overseeing patient care raises significant concerns for patient safety and care coordination.

We thank the New York State Senate and Assembly for again recommending against inclusion of this proposal in the State Budget.

Medicine is rarely simple. Patients frequently present with multiple chronic conditions, complex medication regimens, and evolving symptoms that require careful clinical judgment. Physicians are uniquely trained to evaluate these complexities, interpret diagnostic testing, and adjust treatment plans as patients’ conditions change.

Physician involvement also ensures that patients receive coordinated care across specialties. Without this oversight, there is a risk that important elements of a patient’s health history or treatment plan may be overlooked.

Research has consistently shown that differences in training between physicians and non-physician providers can lead to differences in care patterns, including higher utilization of diagnostic testing and increased health care spending when non-physician providers practice independently. At the same time, surveys repeatedly demonstrate that patients overwhelmingly believe physicians should play a central role in diagnosing their conditions and directing their treatment.

None of this diminishes the critical contributions made by physician assistants and other healthcare professionals. The most effective healthcare systems rely on strong collaboration among all members of the care team.

But collaboration does not mean eliminating the physician’s leadership role. Rather, it means ensuring that every member of the healthcare team practices to the full extent of their training while maintaining the physician oversight that protects patient safety and ensures coordinated care.

As a PA colleague recently told me, “I enjoy being part of a physician led team as a PA. And when utilized correctly PAs do increase access to care. We are not replacements. We all work better when we understand our strengths and limitations.”

As policymakers work to address physician shortages and improve access to care, the focus should remain on solutions that strengthen the healthcare workforce while preserving these essential safeguards.

Increasing support for physician training programs, expanding loan repayment opportunities for physicians who serve in underserved communities, improving New York’s medical practice environment and creating pathways for qualified international medical graduates to practice in New York are all meaningful steps that would help expand access to care.

New York patients deserve a healthcare system that combines the talents of many professionals while maintaining the expertise and leadership physicians provide.

Preserving physician-led care is not about professional titles. It is about ensuring that every patient receives the highest level of medical expertise when making the most important decisions about their health.

That is a goal we should all share.

All the best,

David Jakubowicz, MD, FACS
MSSNY President