Frequently Asked questions:
QUESTION: As a new graduate does a PA need a year of supervision to work at a Urgent Care type clinic if the doctor IS in the same town (less than 1 mile away) and is always available by phone or can stop by?
ANSWER: The rules state that you must have one year experience before working in a remote patient care setting. The rule is interpreted to mean that: 1) new grads cannot work by themselves in any setting, and 2) a new grad can work in a "remote" setting, as long as the doc is on site. A new grad would not be able to work in an Urgent Care Clinic unless the doc was present. One mile away would not be approved by the board.
QUESTION: As a new graduate, my primary is taking two days off for vacation.
My alternate supervisor is down the street. Am I allowed to see
patients in my primary's clinic?
ANSWER: As a new graduate you need to have a
supervising physician on-site most of the day. At least that's how the
Medical Board is going to see it. Working by yourself for 2 days with
the alternate supervisor down the street would be viewed very
unfavorably by the board. This of course would change once you have
been out one year
QUESTION: I need some clarification on the new PA rule 435:15 9-3 that address the 48 hour rule for complex issues.
ANSWER: We are getting a lot of
questions regarding an article hat appeared in the State Medical Board's
newsletter a few weeks ago. Due to the way the article was worded, it
sounded like PAs could not see new patients, unless they were
followed-up by the doctor within 48 hours. To clarify: 1) PAs can see
new patients 2) New patients need to be seen by the doctor within 48
hours IF they have a complex problem . 3)
What constitutes a complex problem is defined by the supervising
physician. An example... a PA working with a cardiologist might not
define angina as a complex problem but a PA working with a Family
physician might.... conversely BPH would not be a complex problem in
family medicine but it would be in cardiology. It would be best if
the doctor and the PA put down on paper conditions (as defined complex
by the doctor) requiring follow-up within 48 hours.
QUESTION: How does the state board look at ownership in a clinic?
ANSWER: Clinic ownership, based on my experiences with the medical board, can be summarized as follows:
1. A PA can own 100% of a clinic IF the PA does not work there. Thus, is not supervised by the physician.
2. If you
work at the clinic, your ownership must not be the controlling interest,
eg, 49% is okay, as long as the other 51% is owned by others not under
your influence (family members, spouse, etc.).
3. You cannot hide behind an LLC or other corporate entity.
Note that
I'm not the final say on clinic ownership. Once you get your business
model ironed out, run it by Asst Attorney General Libby Scott at the
State Medical Board (405) 848-6841.