by Cathy A. Sloane, Esq.
Published in the September/October 2006 Edition of the
Canton/Akron Edition MD News Magazine
On May 17, 2006, a new Physician Assistant law went into effect significantly altering the practice of physician assistants (“PAs”) in Ohio.
Key legislative changes now expanding the autonomy of PAs are:
- Eligible PAs, who meet education and training requirements, can seek prescriptive authority from the Medical Board (“Board”) to prescribe drugs and therapeutic devices, subject to delegation by a supervising physician. The Board must first promulgate rules governing this process before Certificates to Prescribe can be issued to PAs. The final date for adoption of these rules is May 17, 2007.
- The supervising physician is no longer required to countersign every order written by the PA, prior to the order being carried out. Alternatively, the supervising physician must establish a quality assurance system that includes routine review of selected orders and chart entries by the PA. Documentation of the quality assurance activities must be maintained and provided to the Board upon request.
- PAs can evaluate new patients without a prior examination by the supervising physician. The physician must be continuously available for direct communication with the PA, either on the premises or by telecommunication spanning no more than sixty minutes travel time to the location of the PA.
Thinking about utilizing the skills of a PA in your office setting?
If so, the new PA law requires Board approval of: (1) a supervision agreement, (2) a physician supervisory plan, and (3) a special services application if you want the PA to perform services not otherwise listed in the law.
As a supervising physician, you may enter into “supervision agreements” with any number of PAs, but you are not permitted to supervise more than two PAs at any one time. You may select at least two physicians who have agreed to act as alternate supervising physicians when you are not available.
The “physician supervisory plan” describes the scope of PA services and the circumstances in which the PA must refer a patient to you. The statute lists the many services that a PA may perform as part of a standard plan, as long as the service is within your normal course of practice. If the PA will see your patients in the hospital, carefully review the hospital’s policy on PA practices. Although you may always limit a PA’s services beyond what a hospital may allow, the PA cannot exceed the scope of practice permitted by the hospital’s policies.
For more information on these long-awaited changes, see Ohio Revised Code 4730.01-4730.99.
NOTE: This general summary of the law should not be used to solve individual problems since slight changes in the fact situation may require a material variance in the applicable legal advice.