305 Physician Assistant Scope of Practice 2015
ated and served.184 For example, if several PAs and physicians are equally
qualified and available to perform a procedure, but one speaks the language
of the patient, the provider who can describe the procedure in the patient’s
own language is the better choice.185 Patient preference has a role to play as
well.186 When possible, the preferences of individual patients should help
determine which qualified provider is involved in specific aspects of their
Sometimes the most illogical decisions on scope are made in the state
legislature.188 An example of this occurred when the Minnesota state legislature, considering legislation to improve the PA practice act, succumbed to
outside pressure from certified registered nurse anesthetists and barred PAs
from administering certain types of anesthesia.189 The legislature ultimately
passed the bill and the prohibition became law.190 This led to similar anesthesia bans in a handful of other states.191 Since the creation of the PA profession, it has been standard practice for PAs to be trained to perform a
wide variety of medical procedures.192 However, some medical boards have
been slow to relinquish control of specified procedures to other profes-
Ultimately, the PA-physician team best determines PA scope of prac-
184. RUTH BALLWEG ET AL., supra note 101, at 742 (5th ed. 2013).
185. Suad Ghaddar et al., Innovative Approaches to Promote a Culturally Competent,
Diverse Health Care Workforce in an Institution Serving Hispanic Students, 88 ACAD.
MED.1870 (2013) (“The reasons that underrepresentation leads to poor health outcomes and
poor health care quality include cultural distance and language discordance issues between
patients and health care providers.”).
186. BARRYCASSIDY ET AL.,ETHICS ANDPROFESSIONALISM:AGUIDE FOR THE
PHYSICIAN ASSISTANT 25 (2008).
188. Dower et al., supra note 95, at 1973.
189. S. 258, 79th Leg., Reg. Sess. (Minn. 1995).
190. MINN. STAT. ANN. § 147A.09 (1) (West 2014) (stating that PA authority to prescribe, administer, and dispense drugs excludes anesthetics, other than local anesthetics, injected inn connection with an operating room procedure, inhaled anesthesia and spinal anesthesia).
191. See LA. REV. STAT. ANN § 37:1360:31 (2005); MISS. CODE ANN. § 73-26-5 (West
2014); MO. REV. STAT. § 334.735 (2014); OHIO REV. CODE ANN. § 4730.091 (West 2006).
192. AM. ACAD. OF PHYSICIAN ASSISTANTS ET AL., COMPETENCIES FOR THE PHYSICIAN
ASSISTANT PROFESSION 3 (Rev. 2012) (“Physician assistants are expected to. . .perform medical and surgical procedures essential to their area of practice.”).
193. Letter from Susan S. DeSanti et al., Director, F. T. C. Office of Policy Planning, to
Patricia E. Shaner, Office of General Council, Al. State Board of Med. Examiners (Nov. 3,
2010) (“Because the proposed rule effectively prohibits non-physicians from providing interventional pain treatment, and physicians from delegating authority to provide such treatment to other licensed health care professionals, the Proposed Rule appears to prevent
CRNAs from performing many of the pain management procedures that the Board of Nursing considers to be within the scope of CRNA practice in Alabama, subject to physician supervision.”).