Lawmakers weigh transfer of physician‑assistant oversight to Guam medical board amid split views

The Guam Legislature’s Committee on Health held a public hearing on Bill 1‑23, which would transfer licensing and regulatory authority for physician assistants from the Guam Board of Allied Health Examiners to the Guam Board of Medical Examiners.

Sponsor remarks and rationale

Senator Turlahi, who introduced Bill 1‑23, told the committee the measure seeks to modernize Guam’s health‑care regulatory framework by placing physician assistants (PAs) under the medical board, aligning Guam with the majority of U.S. states. “By following the majority approach, Guam ensures alignment with best practices and medical regulation,” the senator said, describing the bill’s intent to formalize collaborative practice agreements and clarify application, registration and rulemaking authority.

Support from PAs and public‑health staff

Ed Stanley, a physician assistant who said he has practiced on Guam for 23 years, told the committee the change is broadly supported by PAs on island. “I think this is definitely a step in the right direction,” Stanley said. He urged the committee to leave technical items about prescriptive scope to rules and regulations rather than the statute and suggested the bill could recognize evolving national professional titles (for example, “physician associate” as an alternate designation).

Department of Public Health and Social Services testimony, read by Heidi Kanata, stated DPHSS supports the proposal, saying it would “create a more streamlined structure in the medical field” and align Guam “with national best practices.” The written testimony said placing PAs under the medical board could reduce administrative complexity and enhance patient safety.

Physician concerns and board composition

Several physicians who testified opposed or cautioned against the change. Ricardo Eusebio, general vascular surgeon and acting chief medical officer at Guam Memorial Hospital, argued a single medical board focused on physicians should not also be expected to regulate clinicians with substantially different training. “There's a different training and the different, the different, roles that the physician provides as compared to what the physician assistant provides,” Eusebio said, adding that mixing licensure responsibilities could create conflicts of interest or oversight bias on a board dominated by physicians.

Board composition and appointment process drew repeated scrutiny. Testimony noted the proposed board would include physician and non‑physician members; physicians warned adding non‑physician members or automatic appointments (for example, the hospital medical director) could politicize oversight or dilute the board’s focus. Several witnesses urged consideration of the board’s appointment process and an increase in public or non‑physician membership to avoid undue political influence.

Prescriptive authority, duplicate registrations and costs

Testimony highlighted inconsistencies in current law and practice about which controlled substances PAs may prescribe. Witnesses described a “patchwork” approach across states: on Guam, PAs currently prescribe schedule 4 and 5 drugs in routine practice, with higher‑schedule prescriptions handled through co‑signatures and supervisory oversight. In committee discussion, Ed Stanley and others recommended leaving exact prescriptive lists to collaborative practice agreements and board rules rather than embedding inconsistent language in statute.

Physicians and PAs also criticized Guam’s local controlled substance registration (CSR) fee. Testimony said the federal Drug Enforcement Administration (DEA) registration costs about $800 for a three‑year period, while Guam’s CSR was recently raised to $500 per year; witnesses called the CSR duplicative of federal registration and urged its removal.

Quotes from the hearing

Ed Stanley, physician assistant, FHP Clinic: “I think this is definitely a step in the right direction. I can't think of a reason that anyone would be in opposition to this bill.”

Ricardo Eusebio, general vascular surgeon and acting chief medical officer, Guam Memorial Hospital: “Why? Number 1, the scope of practice differences. There's significant differences in our scope of practice. And I think it's naive to think that the level of care is the same.”

Next steps and committee response

Committee members asked DPHSS and the Guam Medical Association to provide more detail in markup on board composition, appointment procedures, the relationship between supervising physicians and PAs, and any statutory inconsistencies about prescriptive authority. No final vote or change in law occurred at the hearing. The chair closed the public hearing and encouraged further technical edits and stakeholder consultation before markup.

Ending

The hearing closed with members agreeing to continue consultation in markup; the committee asked DPHSS and professional associations to return with suggested drafting fixes, cost clarifications (including CSR/DEA questions) and options for board composition.