Such agreements allow the PA to exercise clinical judgement while consulting the supervising physician as necessary. The team practice model allows for rapid inclusion of new treatment modalities, individualized approaches to patient problems, and maximization of the supervising physician s ability to direct patient care in the clinical setting. Legal Considerations State laws allow the PA to have more than one supervising physician or to have one primary supervisor and a number of alternate supervisors. Alternate supervisors allow physicians the flexibility to entrust their supervisory responsibilities to physician colleagues. Specific details about shared responsibility for supervision is frequently included in the state PA practice act and regulations.
State laws vary in how they describe supervision and what they require.
They all require ongoing supervision by the physician but most do not require the actual physical presence of the physician at the place where the PA provides care. Generally, the laws require that the supervising physician be immediately available via telecommunication. Some states require countersignature of patient charts within a specified amount of time, but these are the exception, not the rule. Delegation through Practice Agreements When a PA and supervising physician begin practicing together, it is essential that both parties understand how they will work as a team. Developing a practice agreement together through in-depth discussions about scope of practice, supervision, and related issues can help the team to clarify how they will practice and how supervision will be assured.