Title of Proposal:

Amending current Physician Assistant Code to reflect current practices in Medicine

On behalf of:

Virginia Academy of Physician Assistants

Describe the Idea or Issue:

To better reflect current medical practices, harmonize Code with existing regulations, and improve access to care

Desired Outcome:

The introduction of legislation that will;

• Change the definition of Supervision to Collaboration,

• Remove physician liability, except in cases of physician directed care,

• Update Code to reflect current standards of practice,

• Remove current required language requiring attestation in the practice agreement by the physician to allow the establishment of a final diagnosis or treatment plan,

• and remove the barrier as to how many PAs a physician may supervise

Background/Supporting Information:

The delivery of health care by the Physician-PA team continues to undergo change. With the development of unique practice environments, practices need to have the flexibility to respond to rapidly expanding demands. The practice of PAs working side-by-side with physicians on a daily basis has grown to more remote relationships, simply to respond to the ever-increasing demand for access.

The Physician-PA relationship has undergone change, when often the patient load is shared and the care plan jointly determined. The PA profession has grown and proven itself; when initially critically watched and directed (supervision), the practice standard now is more of jointly determined care with willing assistance (collaboration). Indeed, the term supervision has been misunderstood in the administrative world, risking disenfranchisement. The term collaboration will ensure ongoing communication between the Physician and PA team, ensuring the delivery of safe, cost-effective, and quality health care that the patients we serve will benefit from.

The recommended updates to Code will maintain & strengthen the Physician-PA team, while removing unnecessary liability to other team members.

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I disagree with the last line regarding removing the barrier for how many PAs a physician can supervise.  Teachers know well the limits on class size and what happens when it is too large. Removing the barrier on reasonable expectations of collaboration is an invitation to abuse by physicians and amounts to our endorsement of independent practice.

We likely need some codification of the PA/MD role....Good luck maintaining suprvision or collaboration without liability. The trial lawyers will need to get "on board" first (right after they start selling sno-cones in hell).