# Revisiting California’s Supervising Physician-to-Physician Assistant Ratio Requirement: An Urgent Call to Action

## TL;DR

California needs to update its rules on how many physician assistants one doctor can supervise to improve access to primary care.

## Contribution

The paper calls for revising outdated supervision laws to expand healthcare access in California.

## Key findings

- California has the most primary care shortage areas in the U.S.
- Outdated supervision ratios hinder the use of physician assistants in primary care.
- Other states have successfully revised similar laws to improve access.

## Abstract

California like many other states is facing a severe shortage of primary care physicians and access to primary care is uneven across the state. It is well documented that California has the highest number of designated primary care health professional shortage areas in the country. Although physician assistants (PAs) and nurse practitioners (NPs) are estimated to make up a large portion of California’s primary care workforce by 2030, outdated and unnecessary statutory requirements such as the physician-to-PA supervision ratio requirement represent a practice barrier in expanding access to care. Other states have either eliminated or revised their physician-to-PA supervision ratios in favor of expanding access to health care services. Therefore, this editorial represents a call for coordinated actions from local and state entities to address California's outdated physician-to-PA supervision ratio requirement. NPs are mentioned briefly as they have achieved a pathway to full practice authority in California.