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<font size=3>That is a fairly unusual requirement in this day and
age.<br>
In fact, I didn't think any State still required that.<br>
Louisiana does not nor does Missouri (although it does have rather
restrictive language) require the physician to be present.<br>
See below:<br>
From
<a href="http://www.aapa.org/gandp/statelaw.html" eudora="autourl">
http://www.aapa.org/gandp/statelaw.html<br>
</a></font><h4><font face="Times New Roman, Times" size=3><b>LOUISIANA</b>
</font></h4><font face="Times New Roman, Times" size=3><b>
Qualifications:</b> Graduation from accredited PA program and current
NCCPA certification.</font> <br>
<font face="Times New Roman, Times" size=3><b>Application:</b> By PA for
license; by physician for approval to supervise.</font>
<font face="Times New Roman, Times" size=3>Possible interview for initial
license if discrepancies exist. <br>
<b>Scope of practice:</b> Medical services within the PA's education,
training and experience which are delegated by the supervising
physician.<br><br>
<b>Prescribing/dispensing: </b>PAs may prescribe Schedules III-V and
non-controlled medications if delegated by supervising physician to do so
and approved by the board. To be approved for prescribing PA must have a
minimum of one year of clinical rotations during training and have
practiced for a minimum of one year (PAs with less than a full year of
clinical rotations may substitute two years of practice). In order to
prescribe controlled medications, PA must register with state controlled
drug agency and DEA.<br>
<b>Supervision:</b></font>
<font face="Times New Roman, Times" size=3 color="#0000FF"> Continuous
but does not require the physical presence of supervisor at time and
place services are rendered. All written entries by PAs shall be cosigned
by physician within 24 hours for inpatients, acute care settings, and
hospital EDs; 48 hours for nursing home patients and 72 hours in all
other cases. <br>
</font><font face="Times New Roman, Times" size=3><b>Participation in
regulation:</b> Three PAs serve on a five member PA advisory
committee.</font> <br>
<font face="Times New Roman, Times" size=3><b>Louisiana State Board of
Medical Examiners,</b> PO Box 30250, New Orleans, LA 70190-0250;
(504)568-6820.</font> <br>
-------------------------------------------<br>
<h4><font face="Times New Roman, Times" size=3><b>MISSOURI</b></font></h4>
<font face="Times New Roman, Times" size=3><b>Qualifications:</b>
Graduation from accredited PA program and current NCCPA certification.
Person employed as PA for three years prior to August 28, 1989, who has
passed NCCPA exam and has current certification also eligible.</font>
<font face="Times New Roman, Times" size=3>Applicants for licensure who
have graduated from a PA program after January 1, 2008, must have a
master's degree from a PA program. <br>
<b>Application:</b> By PA for license, includes form signed by
supervising physician.</font>
<font face="Times New Roman, Times" size=3>Personal appearance may be
required.<br>
<b>Scope of practice:</b> Histories and physicals; routine office
laboratory and screening procedures; routine therapeutic procedures;
counseling; assisting at surgery; writing orders; other delegated
tasks.</font> <br>
<font face="Times New Roman, Times" size=3><b>Prescribing/dispensing:</b>
Physician assistants shall not prescribe nor dispense any drug, medicine,
device or therapy independent of consultation with the supervising
physician. PAs may prescribe non-controlled medications pursuant to
supervision agreement with supervising physician. Prescriptions shall
include name, address, and telephone number of PA and supervising
physician. Dispensing is limited to 72-hour starter dose supply of
medication.</font> <br>
<font face="Times New Roman, Times" size=3><b>Supervision:</b>
</font><font face="Times New Roman, Times" size=3 color="#0000FF">PA must
practice in same facility as supervising physician. Supervising physician
must be present 66% of the time PA is provising patient care. Physician
must be immediately available for consultation, assistance and
intervention.</font>
<font face="Times New Roman, Times" size=3 color="#0000FF">PA is limited
to practicing in locations where the supervising physician is not further
than 30 miles away. PA and physician practicing in certain settings may
apply for a waiver for alternative supervision and distance requirements.
<br>
</font><font face="Times New Roman, Times" size=3><b>Participation in
regulation:</b> Two PAs serve on a five-member Advisory Commission for
Physician Assistants.</font> <br>
<font face="Times New Roman, Times" size=3><b>Missouri Board of Healing
Arts</b>, State Advisory Commission for Physician Assistants, P.O. Box 4,
Jefferson City, MO 65102; (573)751-0098 or (866)289-5753.</font> <br>
-------------------------------------------------------------------------<br>
<br>
Lorick<br><br>
At 06:06 PM 12/18/2007, you wrote:<br>
<blockquote type=cite class=cite cite=""> <br>
In a message dated 17-Dec-07 10:32:45 Central Standard Time, <br>
M.Jane.Harper@osfhealthcare.org writes:<br><br>
But I don't *believe* that any state allows PAs to hang out their
shingles <br>
in an independent practice the way NPs can in several
states.<br><br>
<br>
Illinois, to my surprised knowledge, apparently does allow PAs to
practice <br>
without the supervising physician present 'on the grounds.'<br>
<br>
There are several urgent care type clinics that I visited out of
curiosity <br>
(mostly in major department/mega stores) where they only had phone
consults.<br>
<br>
Louisiana and Missouri both require a supervising physician to be
'in house' <br>
for the PA to act.<br>
<br>
ck<br>
Charles S. Krin, DO FAAFP<br><br>
<br><br>
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