Drawing on his experience as a physician assistant in the U.S. Army, Jeff Bailes helped get Marietta College's Dr. J. Michael Harding Center for Health and Wellness up and running.
But when it came time to actually start seeing students, there was a problem - despite training as a PA and serving in that capacity through a tour in Bosnia and two in Iraq, under Ohio law, Bailes wasn't a PA.
"I had not anticipated that, and I felt terrible," said Bailes, 49, a Marietta native who lives in Ravenswood, W.Va.
Ohio law requires a person to have a master's degree to be certified as a PA. That's the standard for the Army now too, but it wasn't when Bailes, a 24-year veteran, received his training. Bailes said his understanding of Ohio law led him to believe his military experience qualified him for certification as a PA in the state, but he was mistaken.
"They hired me partially because I have experience turning nothing into a clinic. We did that a lot in the Army," he said. "Here I was not too far out from providing medical care to the troops."
A bill recently passed by an overwhelming majority in the Ohio House of Representatives and now headed to the Senate would allow a person who served at least three consecutive years on active duty as a PA in the military to qualify for state certification. It also expands the duties of PAs and makes it easier for people certified in other states to be certified here.
Highlights of House Bill 284
Authorizes physician assistants to perform additional services, including issuing do-not-resuscitate orders; determining and pronouncing death in certain circumstances; and prescribing, ordering or making referrals for physical and occupational therapy.
Allows individuals with a degree from an accredited program and at least three years of active-duty experience as a physician assistant in the military to qualify for a PA certificate in Ohio.
Allows a PA to qualify for prescription certification if he or she practiced in another state or worked for the federal government.
Bailes was in the House chambers on Wednesday when the bill passed by an 89-3 vote. His high school classmate, state Rep. Andy Thompson, R-Marietta, gave a floor speech in support of the bill and introduced Bailes in the gallery.
Thompson said the bill was already in the works when he found out how it would affect Bailes, so he doesn't take any credit for getting it passed, but was glad to support the legislation. He called the fact that military service didn't count toward certification an "oversight" that many agreed should be corrected.
"That service is certainly valid," he said. "We try to help veterans however we can because they take risks the rest of us don't."
Bailes said even the state medical board, that ultimately ruled the law did not allow him to be certified, felt he should have been.
"I'm in awe of the support that I've gotten from the state medical board, the college and the Ohio government in general," he said.
Bailes has been on administrative leave with the college and plans to return to the clinic once the law goes into effect.
The legislation makes additional changes that will benefit other individuals wanting to use the skills they've developed as PAs, said Gloria Stewart, director of Marietta College's Physician Assistant program. For example, a PA who has practiced in another state or been credentialed by the federal government would not have to undergo the up-to-1,800-hour provisional period to be certified to issue prescriptions.
"It will make it easier for me to come (to Ohio) and find a job as a PA," she said.
The bill also grants PAs the authority to do things like issue do-not-resuscitate orders; pronounce death in certain circumstances; prescribe, order or make referrals for physical and occupational therapy; and insert and remove chest tubes, as well as birth control devices.
Bradley Barnes, a first-year physician assistant student at Marietta, said physician assistants provide a valuable service, especially with a predicted shortage of family practice physicians on the horizon. The more PAs can do, the easier the access to services will be for patients, said Barnes, from Oxford.
"PAs are such an integral part of the health care system and are becoming a lot more integral," said classmate Ellis Thompson, from Akron.
The expanded authority won't require additional training, and it won't mean a PA is operating on his or her own, Stewart said.
"We're not giving PAs carte blanche," Stewart said. "We're still with that team concept of working with the physician."
Another portion of the law would remove barriers to PAs providing medical care in the wake of a disaster. Currently they would have to seek permission from the state board of medicine or risk providing care that wouldn't be covered by malpractice insurance. And those requests have to be made after the disaster happened.
"They couldn't even do it in advance," Stewart said. "We would lose vital time for helping people."
Under the new law, "the PAs, without having to go through a lot of rigmarole and all that, would be able to help under the supervision of their physician," she said.