Supporters say the proposal would help counter a shortage of doctors coming out of medical school and provide a career pathway that doesn't require up to seven years of school and big load of debt. Opponents say the quality of health care will be compromised.

Legislation that would expand the role of physician assistants in medicine passed the state House of Representatives on Thursday despite Republican concerns that it will "water down" the quality of health care.

The bill, introduced by Warwick Democratic Rep. David Bennett, a registered nurse, would allow physician assistants to care for patients without being directly supervised by medical doctors, as long as the two are working "in collaboration."

It would allow physician assistants to be listed as primary-care providers and would relieve doctors of liability for physician-assistants' work.

Supporters of the proposal say it would help counter a shortage of doctors coming out of medical school and provide a career pathway for Rhode Islanders that doesn't require up to seven years of education and an often-crushing debt load.

The Rhode Island Medical Society supports it; dermatologists oppose it.

And Foster Republican Rep. Michael Chippendale argued that expanding the role of physician assistants would compromise medical care.

"I think when someone goes to a doctor appointment and someone comes in with a white coat on, they'll go with it, not asking, 'Hey, are you qualified to be doing this?" Chippendale said. "We are watering down the qualifications of the people who keep us alive."

There were 65 votes for the bill; Chippendale was joined by five fellow Republicans voting against it.

House Speaker Nicholas Mattiello recused himself from the vote because his son, who is in the Bryant University physician-assistant program, was the first witness to testify in support of the bill at a recent House hearing.