Ala. Admin. Code r. 540-X-7-.26 - Limitations Upon Utilization Of Physician Assistants (P.A.)
(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.
Notes
Author: Alabama Board of Medical Examiners
Statutory Authority: Code of Ala. 1975, ยงยง 34-24-290, et. seq.
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