As a new graduate does a PA need a year of supervision to work at an 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?

The rules state that you must have one year of 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.

I need some clarification on the new PA rule 435:15 9-3 that address the 48-hour rule for complex issues.

Due to the way an 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 addressed by the doctor within 48 hours IF they have a complex problem. 3) What constitutes a complex problem is defined by the delegating 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.

How does the state board look at ownership in a clinic?

Clinic ownership, based on our 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 we are 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.