PAs in Puerto Rico: How asociados médicos are persevering through restrictive practice laws.

ABSTRACT: As strained as Puerto Rico's healthcare infrastructure has become in recent years, the island's medical community has long resisted the idea of the physician assistant (PA). After almost 30 years of advocating for the PA profession in Puerto Rico, Law No. 71 was enacted in August 2017, recognizing the PA profession under the title of médico asistente. Eighteen months later, in February 2019, PAs were able to apply for licensure. However, the law as written severely restricts PA medical practice. This article reviews the current status of certified PAs in Puerto Rico and what steps are being taken to establish the profession to ultimately improve health outcomes and expand access to care throughout the island.