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If Your Client Uses a Physician Assistant, Make Sure There's a Written Protocol

By Richard J. Nealon, Esq.
October 07, 2003

Doctors are increasingly making use of physician assistants (PAs) in their practices. In order to avoid liability, it has become imperative that physicians who do use these assistants establish and follow consistent protocols. This is important not only for the efficient and orderly functioning of the office, but to ensure that government regulations are met and that the patients fully understand the role of these professionals. Patients must be told that PAs are available in the practice, but that they as patients have the right to choose examination and treatment by either the assistant or the physician. Only following these protocols can the medical practitioner ensure the orderly function of the office, the satisfaction of the patients, and some degree of protection from lawsuits engendered by a less-than-perfect medical outcome.

Limited Services

By regulation, a PA in the doctor's office may render services only under the supervision of a physician, and may perform medical services only when the duties assigned are related to the designated medical specialty for which he or she is registered. Furthermore, this designated specialty must be within the scope of practice of the supervising physician's practice. A physician should supervise no more than two assistants at any given time. While the supervision must be continuous, the physician need not be physically present while services are rendered by the PA. Within these regulations, there is obviously a great deal of room for flexibility, and the actual work of PAs can vary greatly from one practice to another. Thus the need for a written protocol to define the role of a physician assistant in a given practice.

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