Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-7 - ASSISTANTS TO PHYSICIANS › Section 540-X-7-.23 - Requirements For Supervised Practice - Physician Assistants (P.A.)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Physician
			 supervision requires, at all times, a direct, continuing and close supervisory
			 relationship between a physician assistant and the physician to whom the
			 assistant is registered.
(2) There
			 shall be no independent, unsupervised practice by physician
			 assistants.
(3) The supervising
			 physician shall be readily available for direct communication or by telephone
			 or telecommunication.
(4) The
			 supervising physician shall be available for consultation or referrals of
			 patients from the physician assistant.
(5) In the event the physician to whom the
			 physician assistant is registered is not readily available, provisions must be
			 made for professional medical oversight and direction by a covering physician
			 who is readily available, who is preapproved by the Board of Medical Examiners,
			 and who is familiar with these rules.
(6) In the event of an unanticipated,
			 permanent absence of a supervising physician, a previously approved covering
			 physician may be designated as a temporary supervising physician for a period
			 of up to sixty (60) days. During the sixty (60) day time period, a new
			 registration agreement designating a new supervising physician should be
			 submitted for approval.
(7) If the
			 physician assistant is to perform duties at a remote site, the application for
			 registration must clearly specify the circumstances and provide written
			 verification of physician availability for consultation and/or referral, and
			 direct medical intervention in emergencies and after hours, if indicated. The
			 Board, at its discretion, may waive the requirement of written verification
			 upon documentation of exceptional circumstances. Employees of state and county
			 health departments and facilities certified by the Alabama Department of Mental
			 Health are exempt from the requirement of written verification of physician
			 availability.
(8) The supervising
			 physician and the physician assistant shall adhere to any written guidelines
			 established by the Board to govern the prescription practices of physician
			 assistants.
(9) If the physician
			 assistant is to perform duties at a remote site physician supervision requires
			 the following:
(a) The supervising physician
			 receives a daily status report to be made in person, by telephone, or by
			 telecommunications from the assistant on any complications or unusual problems
			 encountered;
(b) The supervising
			 physician will be present ten percent (10%) of the P. A.'s scheduled work hours
			 in an approved remote practice site if:
1. The
			 P.A. has less than two (2) years (4,000 hours) in a registration agreement.
2. The P.A. has entered into a new
			 registration agreement and the new supervising physician has a dissimilar
			 primary specialty than the previous supervising physician.
(c) If the P.A. has at least two
			 (2) years (4,000 hours) in a registration agreement, the supervising physician
			 shall:
1. Visit the remote site no less than
			 twice a year.
2. Meet with the P.A.
			 no less than quarterly.
(d) A pre-approved covering physician is
			 allowed to be present in lieu of the supervising physician.
(e) The supervising physician, during office
			 visits, if applicable, reviews with the assistant case histories of patients
			 with unusual problems or complications.
(f) An appropriate physician personally
			 diagnoses or treats patients requiring physician follow-up.