On Wednesday, a crucial meeting took place at the South Carolina State House, bringing together legislators and healthcare experts to tackle the pressing issue of a doctor shortage in the state. The focus of the discussion was on potential strategies to mitigate this crisis, including the possibility of expanding the responsibilities of nurse practitioners (NPs) and physician assistants (PAs).

The shortage of doctors is a significant concern across South Carolina, with rural areas feeling the brunt of this scarcity. According to lawmakers, the lack of medical professionals has led to increased wait times and longer journeys for patients seeking care in these communities.

The Association of American Medical Colleges has projected a nationwide shortfall of up to 86,000 doctors by 2036. This looming deficit highlights the urgent need for states like South Carolina to explore alternative solutions to ensure healthcare accessibility for all residents, especially those in less populated areas.

Senate Minority Leader Brad Hutto (D-Orangeburg) emphasized the necessity of addressing this issue creatively. “If we don’t have enough healthcare providers in the pipeline to get to the most rural areas, we’ve got to come up with something that’s going to allow it,” he stated, highlighting the need for innovative approaches to meet healthcare demands.

Currently, state law permits NPs and PAs to diagnose, treat, and prescribe medication, but only under the supervision of a physician. This regulation is among the key topics being reconsidered as South Carolina seeks to enhance its healthcare system to better serve its population.

Lawmakers are now asking whether that supervision is still necessary.

“Because of transportation restraints and other limitations that they [patients] have, they’re not going to make it to a doctor, but they could make it to a nurse practitioner who, in theory, would recognize the very things you’re talking about and send people to the E.R,” Hutto said.

Shannon Cooke, who is a NP, added, “Physicians are often much more limited on time which directly affects patient outcomes… nurse practitioners are able to successfully tackle with knowledge and expertise.”

Many medical leaders argue that supervision remains essential.

Dr. Rebekah Bernard, testified on behalf of South Carolina Medical Association.

“If you get the wrong diagnosis, the wrong medicine, or whatever the situation may be, where if they had waited and seen a physician and that hadn’t happened, potentially, it could be a very different outcome,” Bernard said.

Secretary Robert Kennedy and the Department of Health and Human Services have supported giving nurse practitioners more authority to practice independently, particularly as part of federal rural healthcare initiatives.

But not everyone agrees.

“Is HHS wrong at the federal level to point to nurse practitioners? Is he wrong to point that out as being part of a rural transformation? Yes or no?” said Senator Tom Davis (R – Beaufort).

Bernard said, “Yes. He’s wrong. Yes.”

The bills aimed at expanding practice authority for nurse practitioners and physician assistants are still in committee. Lawmakers are expected to take them up again during the legislative session in January.