Featured photo: Taneisha Franklin believes it presents a problem when PAs like herself are not able to make an initial evaluation and certify individuals as requiring involuntary admission into a psychiatric unit, among other important tasks.
Written by Tanya Terry
Healthcare professionals from around the state are arguing there are serious need to improve healthcare by updating a law they consider outdated.
In the Trauma or Critical Care Department of a local hospital, patients would come in with acute psychosis and clearly met in-patient criteria, but they would be able to leave and harm themselves or others because a physician was not able to do certification paperwork. That’s according to a local PA who worked in the hospital for 15 years.
Taneisha Franklin has been a practicing PA (physician assistant) for the past 18 years and now teaches with the PA program at the University of Michigan-Flint. She believes it presents a problem when PAs like herself are not able to make an initial evaluation and certify these individuals as requiring involuntary admission into a psychiatric unit. If a law many PAs and other health professionals are working to change was changed, a psychiatrist would still evaluate the individual and make the second determination for admission.
“I’m a city of Flint girl,” said Franklin. “I’m a Flint native. I live and was born here in Flint. I work here. My kids are here. I think the mental health aspect of this is so important. You can just see it all over – our level of crime and things. What I experienced when I worked in the Trauma Department, I took care of a lot of patients that were shot. They would come in and have substance issues related to underlying mental issues because they’re hearing voices. So, they were using substances to cope with that. If you could just get them that help, it would be so much better for them.”
Franklin pointed out that when doctors were busy doing other things, PAs were at times trusted, as an extension of the doctors, to make evaluations of patients and have the doctors sign needed forms.
She added PAs received 2-3 years of medical education, where they learn along a medical school model how to take care of patients. Some of their training includes learning about diseases and how to treat them. They learn the signs and symptoms of mental illness, about medications used to treat it and the pharmacology of the medication. They also have a year of actual clinical experience, which includes clinical experience in mental health where they learn about suicidal and homicidal behavior. Lastly, they take a state board test to receive a medical license before optional post-graduate education.
According to the Kaiser Family Foundation, only 36% of mental health care needs are being met in Michigan.
“I do believe it occurs more so in Genesee County,” said Franklin. “If you just look at the amount of mental health providers, workforce shortages are getting lower and lower. That’s one of the reasons that we as PAs in the MAPA (Michigan Academy of Physicians Assistants) are actually lobbying for changes in some of the practice laws.”
House Bill 5114 allows certain healthcare providers to be labeled as mental health providers. Under the bill, PAs, NPs (nurse practitioners) and CNS (clinical nurse specialists) are labeled as mental health professionals. The law currently defines a mental health professional instead as exclusively physicians, psychologists, nurses or a medical social worker. It also includes licensed counselors or licensed marriage and family therapists.
“So, if you’re allowing or excluding certain providers from taking care of patients, you can see how that access is going to be short for those patients. So, what we’re trying to do is get us on the docket to be able to take care of mental illness.”
In addition, a new Harris Poll found that 1 in 3 (31%) of those surveyed gave the state’s current healthcare system a “D” grade or below, which is higher than the national average of 26%.
In the poll of about 2,500 patients conducted in November and December of 2023, Michigan patients cited lack of affordability, the time it takes to get an appointment and feeling rushed during visits as some of the reasons they rated the healthcare system with low grades.
“I feel personally that access to healthcare has definitely taken a toll,” stated Franklin. “Especially since COVID, physician and provider burnout is actually real. Also, there are a large amount of people that feel like if I’m not going to get taken care of, or if it’s going to cost too much, I’m just not going to seek care. So, that access is causing a problem, including workforce shortages within our state.”
Franklin stated outdated laws also prevent PAs from delegating and supervising and practicing in states other than where they were originally licensed as other medical professionals do.
“The other thing we’re looking for is to modernize the PA title…We as Michigan PA and Michigan Association of Physician Assistants have lobbied to have that “A” to mean “associate.” We don’t necessarily assist physicians, but we’re also in collaboration with them. We do work alongside them, but also autonomy from them.”
Franklin said this title better informs patients of the roles PAs play in their healthcare.
If a new bill passes, which is expected to be voted on by the House of Representatives soon, it will take effect 90 days after it’s enacted.
