(H/t to Mr. Stinson for the heads up) House Bill 1241 – Physician assistants. Passed out of committee and is headed to the Senate floor.
Authorizes a physician to delegate to a physician assistant duties that are within the supervising physician’s scope of practice, including prescribing and dispensing certain drugs and medical devices. Requires that a supervising physician must be either: (1) physically present at the location where services are performed by the physician assistant; or (2) immediately available for consultation and in the county or a contiguous county of the location where the services are being rendered or at a hospital or health facility. Requires the supervisory agreement between the physician and the physician assistant to include certain information and be approved by the medical licensing board. Establishes requirements for a physician assistant to prescribe certain drugs. Requires the patient to be seen by the physician in certain circumstances. Changes references from certification to licensure of physician assistants. Makes certain other changes concerning the physician assistant committee and licensure of physician assistants.
If Dr. T is around, I’d be interested in his take on this legislation.
It’s about damn time. I believe this is the last state to give PA’s these responsibilities.
Of course I felt that way about DST so maybe Hoosiers just like being last (or nearly last)!
They play an important role. There’s probably more overlap between a PA and a Nurse Practitioner if this goes into effect. But with projected shortages of primary care providers in the future, PA’s and NP’s can make up the shortfall. The theory is that PA’s can do a lot of the routine medicine, and leave the “hard cases” for MD’s. In practice, this could lead to more MD shortages in small towns. After all, we do make a living off the “easy cases” while remaining available for “hard cases” to trickle in. But I’m sure the market will sort it all out. A single-payer system would probably utilize physician extenders such as NP’s and PA’s quite a bit more.
From a self-interest perspective, this intrudes on my turf a bit. But it really doesn’t get my hackles up, as long as there’s good oversight by a supervising physician–and as long as people understand what they’re getting. The care can be good, but there is some value to having gone through a lot more formal education and residency training. I’m not thrilled about the “as long as the supervising physician is within a county of the PA” deal. I could see a physican employing a bunch of PA’s in widely-spaced clinics while “supervising” from the car and collecting big bucks, with actual patient care suffering.
There are a lot of problems with this bill that I hope the two houses work out before sending it to the governor. Perhaps most important, the only thing that really governs what physicians do with respect to their assistants is what Medicare/Medicaid billing regulations will allow in order to still get reimbursed by CMS. In other words, this bill is somewhat pointless. Unless an assistant can bill for a procedure at the physician’s rate (which they already can under many circumstances) most physicians will still do what is optimal under the payment systems.
I could see a physican employing a bunch of PA’s in widely-spaced clinics while “supervising†from the car and collecting big bucks, with actual patient care suffering.
Well this really isn’t a concern, T, because as I mentioned in my first comment the physician would not get reimbursed by Medicare/Medicaid under these circumstances. For most procedures, the physician must be in the same suite, although that depends on the procedure being performed.
I’m very surprised Pat Miller isn’t actively attempting to kill this bill – she’s the reason the prior iterations have failed, as I recall.
There seems to be a lot of concern over the “bunches” of PAs a physician could employ. My understanding of the bill, is that there is actually a maximum number of PAs a physician can employ – 2.