New Law in Bulgaria provides regulation for Physician Assistants

In a significant move to enhance its healthcare system, Bulgaria’s National Assembly has unanimously passed amendments to the Act on the Professional Organizations of Nurses, Midwives, and Associated Medical Specialists. These changes, approved on second reading, April 2024, establish the Bulgarian Association of Physician Assistants and Feldshers (BAPAF) as the official professional organization for physician assistants in the country.

Prior to this legislative development, physician assistants in Bulgaria operated without a dedicated professional body, despite being authorized to perform specific medical activities, particularly in urgent, emergency, and primary outpatient care. The absence of such an organization posed challenges in maintaining up-to-date professional standards, ethical guidelines, and quality control.

The newly formed BAPAF aims to address these issues by providing a structured platform for physician assistants. It will facilitate the dissemination of current information, establish ethical norms, and promote best practices within the profession. This initiative is expected to elevate the quality of services rendered by physician assistants and ensure more effective oversight of their professional conduct.

The legislative amendments were introduced by Members of Parliament Kostadin Angelov (GERB-UDF), Vasil Pandov (CC-DB), among others, and received unanimous support with 104 votes in favor. This consensus underscores the parliament’s recognition of the critical role that physician assistants play in Bulgaria’s healthcare landscape.

A notable aspect of the amendments is the provision concerning feldshers—a role akin to physician assistants. The law stipulates that until its enactment, feldshers who hold a bachelor’s degree and have practiced a medical profession for at least two years within the last three decades will be granted the rights of physician assistants. This measure acknowledges the experience and contributions of feldshers, integrating them more formally into the healthcare system.

The establishment of BAPAF is anticipated to have a positive impact on various medical fields. Physician assistants in Bulgaria predominantly serve in emergency medicine and surgical departments. However, there is a growing need for their expertise in other specialties, such as obstetrics and gynecology, as well as psychiatric clinics, which are currently facing challenges due to physician shortages.

By formalizing the role and support structure for physician assistants, Bulgaria aims to enhance the efficiency and quality of its healthcare services, ensuring better patient outcomes and addressing the evolving needs of its medical system.

By Scott Smalley, IAPAE Immediate Past President