Last Updated: Oct 14, 2021

Recently we reported on legislation that will, among other things, streamline the process through which physicians must navigate on behalf of their physician assistants (PAs).

You may wonder why PAMED supports this legislation?

PAMED supports legislation that helps our members. A few key benefits to our physician members include;

• The legislation will significantly decrease the “start-up” time required to employ a PA by no longer requiring Medical or Osteopathic Board approval of PA agreements
• The legislation will require the Boards to review 10% of filed agreements each year.
• The legislation will allow physicians to determine the degree of oversight they wish to employ over their PAs as it relates to medical chart reviews
• The legislation continues to require 100% chart reviews for 12 months for new PAs entering the workforce and for those who may be changing medical specialties

These measures no longer require “on-site” supervision of PAs paving the way for physicians to employ telemedicine and other modern communication measures to ensure appropriate oversight. They also increase the allowable supervisory ratio from 1:4 to 1:6. Please note that efforts to remove ratios entirely was rejected by the physician coalition.

What the bill DOES NOT do;

• Expand a PA’s scope of practice

• Diminish a physician’s responsibility to appropriately supervise PAs to ensure the care they are providing to patients is appropriate.

At PAMED’s insistence, and with the support of the physician coalition, language was included that protects physicians who may be asked or forced to supervise more PAs than they feel is clinically appropriate. “This provision of the bill is critical to physicians employed by hospitals who may not feel comfortable supervising a PA they don’t know or being asked to supervise too many PAs at one time," Dr. Michael DellaVecchia, PAMED President notes. “It’s always about patient safety and the delivery of quality health care.”

The bills, SB 397-398, are the product of several years of intense negotiations between a coalition of physician organizations and the PAs, and have been signed into law (now Act 78 and Act 79). The physician organizations included The Pennsylvania Medical Society (PAMED), the Pennsylvania Academy of Family Physicians, the Pennsylvania Chapter of the American Academy of Pediatrics, the Pennsylvania Chapter of the American College of Physicians, and the Pennsylvania Orthopedic Society. The Hospital and Health System Association of Pennsylvania was also a participant in the process of developing the proposals.