P.A. Law Question

[Caverject]

---

Members do not see this ad.

Hey Y'all,

I just have a quick question for everyone since I came across this question the other day. Does a PAC, who no longer works for a physician, still have prescribing rights? Upon graduation from PA school and passing your certification exam, does that give you automatic prescribing rights?

Thank you for your help!

 

[deleted6669]

a pa without a supervising md cannot practice and therefore cannot write scripts. anyone who wants to write for controlled substances be they md/do/pa/np/dpm/etc has to apply for this priviledge with the dea every 3 years and pay the 390 dollar fee. it is not automatic for anyone.

 

[dermpa02]

Upon graduation from PA school and passing your certification exam, does that give you automatic prescribing rights?

Thank you for your help!

To elaborate a bit further -- the states grant prescribing rights. The certification exam has nothing to do with prescribing rights, other than fufilling a state requirement for licensure.

 

[hospPA]

A PA who has prescribing rights in the state in which they are licensed, has prescribing rights by law. But, as EMED said, they cannot use them unless they have a supervising MD/DO. Some states 🙁 🙁 don't even have prescribing rights.
Pat

 

[DrB]

I was wondering what the legal boundaries are for a PA in an emergency situation... say a car accident or some other situation. If no physician is around? Are they protected by the good sam laws?

 

[hospPA]

I was wondering what the legal boundaries are for a PA in an emergency situation... say a car accident or some other situation. If no physician is around? Are they protected by the good sam laws?

We are protected by Good Sam laws as are nurses and any other licensed healthcare provider.

Pat

 

[bennyhanna]

Good sam laws vary by state, and are not national. In many states, you are covered, with the STIPULATION that you respond to the level of care you are trained to, given the situation (obviously, you won't have a crash cart, meds, and IVs with you). Some states do differing laws which could be interpreted as having to respond. Some agencies that employ healthcare workers have stipulations on whether or not to respond, and personal insurance policies vary here too.

Good sam laws, as many can tell you, do NOT prevent you from being sued, they offer limited protections.

There are some gray areas. Identifying yourself as a healtcare provider is like saying, "I'm trained to help, can I help you?" . Many Newbie EMTs and other healthcare providers like to have EMS bumper stickers, or shirts identifying them as healthcare providers. In some states, this can be seen as identifying yourself to the patient as a healthcare provider, and thus would require response... WY and CO have had some court cases with EMTs who have either been wearing EMT shirts or having EMT bumper-stickers, and didn't respond...

I actually worked for an industrial clinic as a medic. We had a worker get in a severe car accident on the way to work, only a mile away. The closest town was 22 miles. This happened around 3:00pm, the time our facility physician leaves. He was aware of this, and rather than stay and treat the patient, or respond to the accident, he took another route around the accident, ensuring that he would not have to render aid. Oddly enough, he is also the medical advisor for the ambulance service that responded (the nearest town). No action was taken, as in my state, response by a healthcare provider is not required.

 

[DrB]

Thank you for the replies... I couldn't help but wonder about the original PAs. As I am aware, the PA profession was developed for combat medics when the returned from a war. These "O.G." PAs were trained for exactly this purpose. I just don't see driving by a car accident, or any other emergency situation, as being true to the spirit of the profession.

There doesn't seem to be any gray area in regards to a PA having to be supervised by a physician, but I was wondering if this rule put a greater limitation on a PA in an emergency situation. Now I am not suggesting a PA whip out his trusty pocketknife and perform emergency face-lifts, but at least CPR... treatment for shock/bleeding?

As a phlebotomist I am not going to stop at a car accident and draw ETOH and CBC, but I know how to stop some bleeding.

Some other things to ponder... emergency childbirth, suicide and others I wouldn't even want to imagine.

 

[DrB]

Physician Assistants and Medical Response to Disasters and Emergencies: Amending State Laws
--------------------------------------------------------------------------------

Physician assistants, like other health professionals, are anxious and willing to provide medical care in an emergency or disaster situation. But most state laws do not contain the language that would allow this to happen. In most states, PAs are in violation of the law if they assist in emergency or disaster relief efforts.

The laws governing PA practice reflect two key principles: supervision by licensed physicians and physician delegation. The profession endorses these concepts. However, state law exemptions to these requirements are necessary to allow PAs to respond to exceptional circumstances created by disasters or emergencies in the field.

Physician assistants are trained at accredited programs associated with medical schools and teaching hospitals. PA education is a foreshortened version of the medical school curriculum, with a focus on primary care. Although physician assistants may work in subspecialty fields with physician specialists as their supervisors, all PAs have a generalist core of medical knowledge. This allows them to be extremely useful in responding to medical needs created by unanticipated events that cause injury or illness.

State laws should be amended so that PAs can provide emergency field response to illness, injury, or disaster. Four specific provisions are needed to address situations that occur outside the PA's place of employment.

Good Samaritan immunity should be granted to PAs and any physicians who supervise them when they are helping victims of accidents and disasters outside of established medical settings.
Supervision requirements should permit physicians to supervise PAs without filing for approval from the state licensing authority when they are working with a PA in emergency field response.
PAs should be permitted to respond to disasters and unusual emergencies with supervision by physicians who are also volunteering in these efforts. If there are no physicians present, PAs should be allowed to provide medical care.
Federally-employed PAs, and PAs who are licensed in other states, should be permitted to respond to a need for medical care in disasters and emergencies.
The AAPA has drafted model language that can be used to amend state laws:

Participation in Disaster and Emergency Care

A physician assistant licensed in this state or licensed or authorized to practice in any other U.S. jurisdiction or who is credentialed as a physician assistant by a federal employer who is responding to a need for medical care created by an emergency or a state or local disaster (not to be defined as an emergency situation which occurs in the place of one's employment) may render such care that they are able to provide without supervision as it is defined in this section of law, or with such supervision as is available.

Any physician who supervises a physician assistant providing medical care in response to such an emergency or state or local disaster shall not be required to meet the requirements set forth in this section of law for a supervising physician.

No physician assistant licensed in this state or licensed or authorized to practice in other states of the United States who voluntarily and gratuitously, and other than in the ordinary course of employment or practice, renders emergency medical assistance shall be liable for civil damages for any personal injuries which result from acts or omissions by those persons in rendering emergency care which may constitute ordinary negligence. The immunity granted by this section shall not apply to acts or omissions constituting gross, willful, or wanton negligence or when the medical assistance is rendered at any hospital, physician's office, or other health care delivery entity where those services are normally rendered. No physician who supervises a physician assistant voluntarily and gratuitously providing emergency care as described in this subsection shall be liable for civil damages for any personal injuries which result from acts or omissions by the physician assistant rendering emergency care.

 

[bananaface]

Things like CPR, controlling bleeding, and emergency childbirth are situations in which you would want any bystander who could help to do so until EMS arrived. It's not as if the actions performed are elective. I don't see scope of practice as being such an issue for those scenarios.