Cal. Code Regs. Tit. 16, § 1399.545 - [Operative until 10/1/2024] Supervision Required
(a) A
supervising physician shall be available in person or by electronic
communication at all times when the physician assistant is caring for
patients.
(b) A supervising
physician shall delegate to a physician assistant only those tasks and
procedures consistent with the supervising physician's specialty or usual and
customary practice and with the patient's health and condition.
(c) A supervising physician shall observe or
review evidence of the physician assistant's performance of all tasks and
procedures to be delegated to the physician assistant until assured of
competency.
(d) The physician
assistant and the supervising physician shall establish in writing transport
and back-up procedures for the immediate care of patients who are in need of
emergency care beyond the physician assistant's scope of practice for such
times when a supervising physician is not on the premises.
(e) A physician assistant and his or her
supervising physician shall establish in writing guidelines for the adequate
supervision of the physician assistant which shall include one or more of the
following mechanisms:
(1) Examination of the
patient by a supervising physician the same day as care is given by the
physician assistant;
(2)
Countersignature and dating of all medical records written by the physician
assistant within thirty (30) days that the care was given by the physician
assistant;
(3) The supervising
physician may adopt protocols to govern the performance of a physician
assistant for some or all tasks. The minimum content for a protocol governing
diagnosis and management as referred to in this section shall include the
presence or absence of symptoms, signs, and other data necessary to establish a
diagnosis or assessment, any appropriate tests or studies to order, drugs to
recommend to the patient, and education to be given the patient. For protocols
governing procedures, the protocol shall state the information to be given the
patient, the nature of the consent to be obtained from the patient, the
preparation and technique of the procedure, and the follow-up care. Protocols
shall be developed by the physician, adopted from, or referenced to, texts or
other sources. Protocols shall be signed and dated by the supervising physician
and the physician assistant. The supervising physician shall review,
countersign, and date a minimum of 5% sample of medical records of patients
treated by the physician assistant functioning under these protocols within
thirty (30) days. The physician shall select for review those cases which by
diagnosis, problem, treatment or procedure represent, in his or her judgment,
the most significant risk to the patient;
(4) Other mechanisms approved in advance by
the board.
(f) The
supervising physician has continuing responsibility to follow the progress of
the patient and to make sure that the physician assistant does not function
autonomously. The supervising physician shall be responsible for all medical
services provided by a physician assistant under his or her
supervision.
Notes
2. Amendment filed 7-12-85; effective thirtieth day thereafter (Register 85, No. 28).
3. Amendment of subsection (e)(3) and repealer of subsection (g) and relettering filed 1-28-92; operative 2-27-92 (Register 92, No. 12).
4. Change without regulatory effect repealing subsection (f) and relettering subsections filed 10-12-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 42).
5. Change without regulatory effect amending subsection (e)(4) filed 8-7-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 32).
Note: Authority cited: Sections 2018, 3502 and 3510, Business and Professions Code. Reference: Sections 3502 and 3516, Business and Professions Code.
2. Amendment filed 7-12-85; effective thirtieth day thereafter (Register 85, No. 28).
3. Amendment of subsection (e)(3) and repealer of subsection (g) and relettering filed 1-28-92; operative 2-27-92 (Register 92, No. 12).
4. Change without regulatory effect repealing subsection (f) and relettering subsections filed 10-12-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 42).
5. Change without regulatory effect amending subsection (e)(4) filed 8-7-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 32).
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(a) A supervising physician shall be available in person or by electronic communication at all times when the physician assistant is caring for patients.
(b) A supervising physician shall delegate to a physician assistant only those tasks and procedures consistent with the supervising physician's specialty or usual and customary practice and with the patient's health and condition.
(c) A supervising physician shall observe or review evidence of the physician assistant's performance of all tasks and procedures to be delegated to the physician assistant until assured of competency.
(d) The physician assistant and the supervising physician shall establish in writing transport and back-up procedures for the immediate care of patients who are in need of emergency care beyond the physician assistant's scope of practice for such times when a supervising physician is not on the premises.
(e) A physician assistant and his or her supervising physician shall establish in writing guidelines for the adequate supervision of the physician assistant which shall include one or more of the following mechanisms:
(1) Examination of the patient by a supervising physician the same day as care is given by the physician assistant;
(2) Countersignature and dating of all medical records written by the physician assistant within thirty (30) days that the care was given by the physician assistant;
(3) The supervising physician may adopt protocols to govern the performance of a physician assistant for some or all tasks. The minimum content for a protocol governing diagnosis and management as referred to in this section shall include the presence or absence of symptoms, signs, and other data necessary to establish a diagnosis or assessment, any appropriate tests or studies to order, drugs to recommend to the patient, and education to be given the patient. For protocols governing procedures, the protocol shall state the information to be given the patient, the nature of the consent to be obtained from the patient, the preparation and technique of the procedure, and the follow-up care. Protocols shall be developed by the physician, adopted from, or referenced to, texts or other sources. Protocols shall be signed and dated by the supervising physician and the physician assistant. The supervising physician shall review, countersign, and date a minimum of 5% sample of medical records of patients treated by the physician assistant functioning under these protocols within thirty (30) days. The physician shall select for review those cases which by diagnosis, problem, treatment or procedure represent, in his or her judgment, the most significant risk to the patient;
(4) Other mechanisms approved in advance by the board.
(f) The supervising physician has continuing responsibility to follow the progress of the patient and to make sure that the physician assistant does not function autonomously. The supervising physician shall be responsible for all medical services provided by a physician assistant under his or her supervision.
Notes
2. Amendment filed 7-12-85; effective thirtieth day thereafter (Register 85, No. 28).
3. Amendment of subsection (e)(3) and repealer of subsection (g) and relettering filed 1-28-92; operative 2-27-92 (Register 92, No. 12).
4. Change without regulatory effect repealing subsection (f) and relettering subsections filed 10-12-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 42).
5. Change without regulatory effect amending subsection (e)(4) filed 8-7-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 32).
Note: Authority cited: Sections 2018, 3502 and 3510, Business and Professions Code. Reference: Sections 3502 and 3516, Business and Professions Code.
2. Amendment filed 7-12-85; effective thirtieth day thereafter (Register 85, No. 28).
3. Amendment of subsection (e)(3) and repealer of subsection (g) and relettering filed 1-28-92; operative 2-27-92 (Register 92, No. 12).
4. Change without regulatory effect repealing subsection (f) and relettering subsections filed 10-12-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 42).
5. Change without regulatory effect amending subsection (e)(4) filed 8-7-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 32).