Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-7 - ASSISTANTS TO PHYSICIANS › Section 540-X-7-.26 - Limitations Upon Utilization Of Physician Assistants (P.A.)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A supervising
			 physician must be present in the operating room or be immediately available to
			 that operating room whenever a physician assistant is involved in the care of a
			 patient in the operating room. Whenever a physician assistant performs or
			 assists in performing invasive procedures with involvement deeper than the
			 complete dermis, the supervising physician must be present in the operating
			 room, unless otherwise specifically approved by the Board.
(2) The cumulative work time for all
			 physician assistants being supervised by an individual primary supervising
			 physician shall not exceed three hundred and sixty (360) hours (nine FTEs) per
			 week. The physician shall not supervise or collaborate with any combination of
			 assistants to physicians, certified registered nurse practitioners, and/or
			 certified nurse midwives exceeding three hundred and sixty (360) hours per week
			 (nine full-time equivalent positions). "One full-time equivalent" (FTE") is
			 herein described as a person/persons collectively working forty hours a week,
			 excluding time on call.
(3) A
			 physician collaborating with or supervising more than four FTEs per week shall
			 engage in documented quality assurance review with each physician assistant
			 every month for six (6) months following registration with a new physician
			 assistant.
(4) A physician shall
			 disclose to the Board of Medical Examiners the existence of all collaborative
			 and supervisory agreements to which the physician is party, including
			 collaborative and supervisory agreements in other states, and shall not be
			 eligible to collaborate with or supervise any combination of certified
			 registered nurse practitioners, certified nurse midwives and/or assistants to
			 physicians exceeding three hundred and sixty (360) hours per week (nine
			 full-time equivalent positions), inclusive of collaborative and supervisory
			 agreements existing in other states. Agreements with an individual certified
			 registered nurse practitioner, certified nurse midwife, and/or assistant to
			 physician in multiple states shall only be counted once for purposes of
			 calculating the total number of full-time equivalent positions.
(5) A physician assistant may be registered
			 to more than one supervising physician at any one time. The number of
			 supervising physicians to whom a physician assistant may be registered shall be
			 restricted by the Board if the Board, in its discretion, determines that such
			 restriction is appropriate to maintain the quality of medical services being
			 provided or to otherwise protect the public health, safety and
			 welfare.
(6) A physician in a
			 registration agreement/ collaboration with a Physician Assistant, Certified
			 Registered Nurse Practitioner or Certified Nurse Midwife totaling three hundred
			 and sixty (360) hours per week (nine (9) full-time equivalents (FTEs)) may
			 request a transitional allowance increasing the total weekly hours for the
			 purpose of orientation of the incoming Physician Assistant. The transitional
			 allowance shall not exceed forty-five (45) days. The physician shall request
			 the transitional allowance in writing and specify the starting date of this FTE
			 allowance.
(7) Employees of the
			 State Health Department or of a county board of health are specifically exempt
			 from the requirements of paragraph (2) of this rule. The Board of Medical
			 Examiners, in its discretion, may determine how many physician assistants may
			 be registered to and/or supervised by a physician employed by the State Health
			 Department or by a county board of health.
Author:
Alabama Board of Medical
				  Examiners
Statutory Authority:
Code of Ala.
				  1975
, §§
										34-24-290,
et
.
seq
.