331 Physician Assistant Scope of Practice 2015
hough there are times when physicians act in a traditional supervisory role
with PAs, labeling every physician-PA relationship with “supervision” fails
to convey the sophistication of the team and to recognize the vast amount of
autonomous decision making involved in PA practice. 408
According to Guidelines, “[t]he guiding principles of supervision must
be that it (a) protects the public health and safety, and (b) preserves the physician assistant’s access to physician consultation when indicated.” 409 While
public protection and access to physician consultation are key to safe and
effective team practice, it has been suggested that the term “supervision” is
no longer appropriate and serves as a barrier to accurate perception of the
profession by the public and achievement of legal authority for full scope of
practice. 410 The ideal way to address this is to universally refer to physician
assistants as “PAs” and to describe the way physicians and PA work together as “collaboration.”411
VI. THE FUTURE – NEW FOCUS, LESS FIGHTING
On Oct. 1, 2013, the Michigan Senate introduced an omnibus bill (Senate
Bill 568), which totaled more than 230 pages, amending several chapters of
the Michigan Public Health Code.412 The intent of the bill is “to reform the
current structure of healthcare provider occupational licensing to reflect the
changing dynamics of the healthcare marketplace” by addressing scope-of-practice issues for PAs and nurses.413 The legislation seeks to consolidate
the regulations and oversight of allopathic and osteopathic physicians, PAs,
and advanced practice registered nurses by repealing parts of the state’s
public health code to create the Michigan Patient Care Board (“Patient Care
It is the responsibility of the PA to seek advice and consultation when indicated. PAs are
often credited with the strength of “knowing their limits” and understanding when physician
input should be solicited.”).
408. The Role and Definition of a Physician Assistant, supra note 405; See also RUTH
BALLWEG ET AL., supra note, 101 743-4 (5th ed. 2013) (“ A central theme of the supervisory
relationship between physicians and PAs is the recognition that the physician is the most
comprehensively trained member of the team and therefore holds terminal responsibility for
ensuring that all members of the team adhere to accepted standards of care. He or she assumes legal liability and professional responsibility for all medical actions of the PA.”).
409. AM.ASS’N OFPHYSICIANASSISTANTS,GUIDELINES FORSTATEREGULATION OF
PHYSICIAN ASSISTANTS 3-4, available at https://www.aapa.org/WorkArea/Download
Asset.aspx?id=795 (last visited Nov. 17, 2014).
410. Id. at 4-5.
411. See Lawrence Herman, Tsunami of Change, PA PROF., May 2014, at 3 (“We have
changed how we tell the PA story: specific words have been eliminated from the AAPA vocabulary entirely or diminished to a minimum. We are now simply PAs, just as physicians
are MDs [and DOs] and nurses RNs.”); see also AAPA HOD Res., supra note 405.
412. S. 568, 97th Leg., Reg. Sess. (Mich. 2013).
413. Mich. Health and Hosp. Association, Sen. Jim Marleau Addresses MHA Legislative Policy Panel, Vol. 44 No. 35 MICH. HEALTH & HOSP. ASS’N, (October 28, 2013), available at http://www.mha.org/mha/weeklymailing/2013/102813/monday_report.htm.