While maybe not as excited as Navin R. Johnson was in The Jerk when the new phone books finally arrived, physicians and physician assistants should nevertheless be pleased about recent changes in the laws and rules relaxing strict supervision requirements and bringing physician assistant practice into the digital age of electronic media.
Over the past year, greater access to healthcare, particularly in rural Oklahoma, has been given a boost thanks to a change in the Physician Assistant Act. Last November, the act was amended, taking away the longstanding requirement that a supervising physician must be physically onsite with the physician assistant supervising him or her at least one-half day a week. Finding a supervising physician willing to travel great lengths to satisfy the Oklahoma State Medical Board’s onsite supervision requirements was often an issue, especially in remote areas of the state.
Now, as long as the physician and physician assistant can be easily in contact with each other through any means of telecommunication (i.e., telephone, internet, Skype, FaceTime, etc.) the physician is no longer required to travel to the physician assistant’s office for any onsite supervision each week.
Effective August 26, 2016, the Medical Board will take this one step further by changing the Physician Assistant Rules. Under the new rules, a physician will be able to supervise up to four physician assistants at one time instead of two physician assistants as was the rule in previous years. With the high demand for physician assistants in primary care settings, finding supervising physicians not already committed was sometimes difficult. By expanding the rule, this will open the door for more physician assistant owned clinics and more widespread staffing of emergency departments by physician assistants, especially in Oklahoma’s underserved and rural areas.
Although these changes have the potential to greatly expand the physician assistant practice throughout the state, keep in mind that physician assistants are still required to have a supervising physician. This means consultation and periodic chart review (which may be by telecommunications) as determined by the supervising physician. Physician assistants are also not allowed to employ their supervising physicians under the Medical Board’s laws and rules. This can make it tricky when setting up a physician assistant owned and operated practice.
Physician assistants must carefully choose a business entity where they can own and run their business, have a supervising physician to oversee their practice, even if remotely, pay this supervising physician for his or her services, yet not employ the supervising physician. A carefully drafted contract between the physician assistant and the supervising physician will protect both persons and is recommended to negate any appearance that the physician is an employee of the physician assistant.
If you have any questions about the new rules or need assistance, either as a physician assistant setting up a practice or as a physician contemplating a supervision relationship, please contact Elizabeth Scott or any member of Crowe & Dunlevy’s Administrative & Regulatory or Healthcare Practice Groups.