Column: Lift Prescription Restrictions on Health Professionals

"Column: Lift Prescription Restrictions on Health Professionals," by Sam Vafadar, as a special to the Tampa Bay Times:

"I am a fairly new physician assistant who has been working in a very specialized field of medicine called thoracic medical oncology. But I can already see that a key way to provide better care — and to prevent controlled substance abuse — is to grant both physician assistants (PAs) and nurse practitioners (ARNPs) full prescribing authority of controlled substances, as deemed appropriate by our supervising physician colleagues.

"Florida is the only state that does not permit mid-level providers (PAs and ARNPs) to do this. As a Florida native and a practicing physician assistant who works at Moffitt, the state's only National Cancer Institute-designated comprehensive cancer center, I strongly hope that bills making their way through the Legislature will become law and correct this mistake. In oncology there is a dire need for more flexibility in prescribing controlled substances.

"I am an advanced practice professional (APP) — also known as a mid-level provider — in oncology, which means I am involved in complex decisionmaking for patients with unique and challenging needs. And more often than not, I see these patients in follow-up more frequently than do my physician colleagues. Quite simply, we develop our own unique, complex provider-patient relationships over time. We are frequently looked to as the patient's health advocate, essentially representing the patient for our physician colleagues. And because we know our patients so well, we are best positioned to know what they need to ease their pain — but also to recognize warning signs of abuse.

"As one of the few sub-specialized PAs in the state, I witness on a daily basis the negative impact that restricted prescribing laws have on Floridians, especially those affected with a cancer diagnosis. As a PA in a cancer center, I work with many specialists to coordinate and to optimize patient care, interpreting subjective and objective data to best aid the patient as a cancer survivor, working with medical oncologists to optimize patient outcomes, and prescribing oral and IV medications when appropriate within the scope of practice as allowed by my institution.

"I can do all of those things, except efficiently and effectively relieve the pain and suffering in a patient population that research has shown to be the least likely to abuse controlled substances.

"Senate Bill 614, sponsored by Sen. Denise Grimsley, R-Sebring, would give PAs and ARNPs the authority to prescribe controlled substances as determined appropriate by supervisory physicians. It would not remove any decisionmaking power from the physician. This bill — and a similar bill in the House, HB 281 — will go a long way to ensure that an additional 20,000 providers will be able to treat patients to the level of our training and education.

"No state that gave PAs or ARNPs full prescriptive authority has ever rescinded it. Passing this legislation will help to keep my PA and ARNP colleagues who were trained in Florida, practicing in Florida. It will improve access to health care for all Floridians and create more jobs.

"I appreciate that the Florida Legislature may finally be considering a law that, in my opinion, is long overdue and that will no doubt positively affect health outcomes for all Floridians. I am both a proud, native Floridian and a physician assistant who wants this state to succeed. However, current restrictive prescribing laws are preventing optimal outcomes. I believe that this is a crucial next step in our health care evolution."

Sam Vafadar is a physician assistant in thoracic oncology at Moffitt Cancer Center in Tampa. He wrote this exclusively for the Tampa Bay Times.