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UPAP Alumna Grows The PA Profession in Puerto Rico


The healthcare system in Puerto Rico, an unincorporated territory of the United States, has been strained for several years, with hospitals and other medical systems battling underfunded programs, the aftereffects of 2017’s Hurricane Maria, and the COVID-19 pandemic. Despite the desperate need for on-the-ground practitioners, the government of Puerto Rico has been reluctant to include asociados medicos—the Spanish term for Physician Assistants (PA)—into its registers of medical workers licensed to practice in the territory. It wasn’t until 2019 that PAs in Puerto Rico were able to apply for medical licensure, following years of advocacy and pressure from PA groups in the area and the mainland. And at the forefront of this activism is Laura Juarez, MPAS, PA-C, MPH, a graduate of DFPM’s Utah Physician Assistant Program (UPAP).


Juarez moved to Puerto Rico in 2018, excited to join the healthcare profession in the area, but soon discovered a multitude of barriers restricting PA practice and licensure. Determined to carve out a space for PAs in the area, however, she joined the San Juan Bautista School of Medicine in 2020 and submitted paperwork to develop Puerto Rico’s first PA program developed entirely in Puerto Rico. The program immediately began its programming, matriculating the first PA students in January 2021. Juarez herself finally received Puerto Rican PA licensure at that time, making her one of the very first certified PAs in the territory.

From there, Juarez has leveraged her status as one of Puerto Rico’s few PAs to provide support to the fledgling profession. Along with her colleagues, Juarez established the Academia de Asociados Medicos de Puerto Rico, an organization of PAs in the area recognized by the American Academy of Physician Assistants (AAPA) in the summer of 2021, and Juarez was able represent the territory for the first time ever in the AAPA conference in May 2022. The group also put together the first PA conference established in Puerto Rico, “Partners in Healthcare for Puerto Rico.” The event brought asociados medicos to the table with physicians and legislators, giving them a voice in discussions of important local health issues for the Puerto Rican people.

Puerto Rico’s growing recognition of associados medicos as distinct from other medical workers represents an important shift in the way that PAs are thought of in the territory. “The reason this matters so much relates back to our legislative efforts where Puerto Rico [originally] chose to say “medico asistente” in an effort to group together everyone from unmatched medical grads to medical assistants,” says Juarez. “It’s also exciting because as AAPA launches the national title change in English (from Physician Assistant to Physician Associate) we are now getting Spanish translated documents to support this with Asociado Médico!”

Juarez continues to fight for the establishment of PA practice in Puerto Rico, and is currently working full-time to develop and champion laws to solidify the position of the PA profession in the territory. She recently co-wrote an article “How asociados médicos are persevering through restrictive practice laws” describing the challenges and potential of PAs in Puerto Rico’s healthcare systems. She also is part of the team putting forward a petition championing the utilization of associados medicos in Puerto Rico’s healthcare systems.

“Our ask is truly for health equity, for the 3.2 million residents of Puerto Rico, by allowing graduate trained, certified, licensed PAs/Asociados Medicos to provide access to care,” says Juarez. “I believe in the motto that PAs can be part of the solution.”