AAPA president: Emergency care, not independent practice, was the focus of Hawaii and Illinois laws about PAs

LETTER — Posted Feb. 15, 2010

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We appreciate American Medical News printing the correction to the Jan. 18 article entitled, "Organized medicine pushes back on expansions of scope of practice" (Article, Jan. 18). As noted in the correction, the article incorrectly portrayed physician assistants as pursuing independent practice in Hawaii and Illinois.

All PA state laws require that physician assistants practice with physician supervision. PAs and the American Academy of Physician Assistants support this concept as a pillar of the PA profession.

AAPA believes that physician-PA team practice enhances patient care. However, there is one circumstance in which a supervision requirement is problematic. That occurs when a PA unexpectedly encounters a situation in which medical assistance is required outside of the PA's usual place of employment. Physician delegation to provide care will not be available, and it is unlikely that the PA will be able to access his or her usual physician supervision.

The Hawaii and Illinois legislation create a solution to this problem. When a disaster or emergency occurs and medical care is required, physician assistants, like all health professionals, have an ethical duty to assist to the extent they are able. The Hawaii and Illinois bills lift the supervision requirement in these narrowly defined situations.

The legislation included protections for physicians. In some emergencies, PAs and physicians may both arrive on the scene. In these instances, PAs will act like PAs and physicians will act like physicians. The doctors will supervise, and the PAs will practice with the supervision of any physician who is available. The bills protect physicians by stating that doctors could not be disciplined for failure to have state approval, and would not be subject to liability for any action of the PA.

At present, about half the states have laws in place that exempt PAs from supervision requirements if they respond in an emergency that is outside of their regular work environment when no physician is available. Our intent in this is clearly stated in this issue brief (link).

The article's reference to PA prescribing bills implied that these were opposed by organized medicine. In actuality, the bills authorize PA prescribing when delegated by a supervising physician. Neither the Hawaii Medical Assn. nor the Illinois State Medical Society opposed either piece of legislation.

The academy and the PA profession place a strong value on the relationship we have with physicians both in the clinical setting and in the policy arena.

We appreciate the correction previously printed by American Medical News and the opportunity to provide this additional clarification.

Stephen H. Hanson, MPA, PA-C, president, American Academy of Physician Assistants

Editor's note: The correction ran in our Feb. 8 print edition and also appears online.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2010/02/15/edlt0215.htm.

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