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Hiring a PA

Hiring A Physician Assistant: A Guide for Physicians and Institutions

 

Facts About Physician Assistants

 

Physician Assistants (PAs) are health care professionals licensed to practice medicine with physician supervision.The physician-PA team enhances medicine because PAs are trained as clinical partners to provide physician-directed medical care. Physician assistants are found in virtually every type of practice setting, are employed by solo physicians and major corporations, and work in nearly every medical and surgical specialty and sub-specialty area.

 

PAs Routinely:

  • Perform physical exams and obtain patient histories
  • Order and interpret tests
  • Diagnose and treat illnesses
  • Assist in surgery and provide preoperative and postoperative procedural care
  • Prescribe medications
  • Provide health education, patient counseling, promote preventative health strategies

 

PA Education

 

PAs are trained in intensive medical education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. Admission to PA school is highly competitive, pre-requisites analogous to premedical study requirements for medical students. The average length of a PA education master’s program is 27 months, a combination of classroom and clinical rotations.

 

Classroom education encompasses the core sciences: anatomy, physiology, pharmacology, physical diagnosis, pathophysiology, behavioral science, and medical ethics.

 

During clinical rotations more than 2000 hours are completed with family medicine, internal medicine, obstetrics and gynecology, pediatrics, general surgery, emergency medicine, psychiatry, and elective specialties.

 

PA Credentials

 

After graduation, PAs are required to pass a national certifying examination in order to practice. South Carolina does provide temporary approval until the new PA graduate takes the next available exam and receives his or her scores. The exam is administered by the NCCPA and is provided at testing centers throughout the nation. To maintain current certification—required for renewal in South Carolina—PAs must complete 100 hours of CME every two years and take a recertification exam every ten years.

 

Benefits of Hiring a PA

 

Physician assistants are highly educated licensed medical providers who work on the physician led team to:

  • Increase access to medical care for patients
  • Increase provider-patient interactions and rapport
  • Increase patient satisfaction with the services they receive
  • Increase the productivity of the medical practice
  • Increase the amount of time a physician has for personal endeavors

 

PA Practice and Prescriptive Authority

 

Physician assistants in South Carolina practice medicine according to Scope of Practice Guidelines that are developed by the individual PA and his or her supervising physician. The guidelines are based on the PA’s experience and expertise, the physician’s wishes about what is delegated, any specific restrictions in the state’s laws or regulations, and any restrictions of the employing institution. Physicians can delegate prescriptive privileges to PAs in South Carolina. According to current regulations, PAs may prescribe non-controlled and Schedule II - V controlled medications that are included in the PA’s Scope of Practice Guidelines. PAs who prescribe controlled substances must obtain their own DEA numbers. PAs in South Carolina are allowed to provide patient services in sites where the physician is not present all of the time, but they do not practice independently. PAs always have one main supervising physician and can have multiple alternate physicians.

 

New legislation was recently passed which will allow for PAs to write for Schedule II medications under certain circumstances. For more information, please visit our Legislation page.

 

AMA Guidelines for Physician-Physician Assistant Practice

 


Adopted by the AMA House of Delegates, June 1995.

  • The physician is responsible for managing the health care of patients in all settings.
  • Health care services delivered by physicians and physician assistants must be within the scope of each practitioner’s authorized practice, as defined by state law.
  • The physician is ultimately responsible for coordinating and managing the care of patients and, with the appropriate input of the physician assistant, ensuring the quality of health care provided to patients.
  • The physician is responsible for the supervision of the physician assistant in all settings.
  • The role of the physician assistant in the delivery of care should be defined through mutually agreed upon guidelines that are developed by the physician and the physician assistant and based on the physician’s delegatory style.
  • The physician must be available for consultation with the physician assistant at all times, either in person or through telecommunication systems or other means.
  • The extent of the involvement by the physician assistant in the assessment and implementation of treatment will depend on the complexity and acuity of the patient’s condition and the training and experience and preparation of the physician assistant, as adjudged by the physician.
  • Patients should be made clearly aware at all times whether they are being cared for by a physician or physician assistant.
  • The physician and physician assistant together should review all delegated patient services on a regular basis, as well as the mutually agreed upon guidelines for practice.
  • The physician is responsible for clarifying and familiarizing the physician assistant with his or her supervising methods and style of delegating patient care.

 

State Regulation

 


The employer should contact the South Carolina Board of Medical Examiners at the address below to request a copy of the laws and regulations governing PA practice.

South Carolina Board of Medical Examiners

PO Box 11289

Columbia, SC29211-1289

803/896-4500

 

Brief Summary of State Law

 

Qualifications: Graduation from an accredited PA program, current NCCPA certification required for initial and renewed registration.Temporary approval for new graduates is allowed.

 

Application: By PA and supervising physician (includes personal interview with a South Carolina Board of Medical Examiners [SCBME] member)

 

Scope of Practice Guidelines: Developed by PA and supervising physician specific to practice setting

 

Supervision: The new law no longer specifies the percentage of time the physician must be physically present in either the onsite or offsite practice settings. An offsite practice can now be within a 60 mile radius from the primary practice setting. Howeverm the physician must co-sign, at a minimum, 10% of the charts. If a physician/PA team wants the PA to work in an offsite practice site, they must work as a team for 6 months before requesting approval by the BME. The practice guidelines should stipulate the percent of charts to be co-signed; however, it should not be less than 10%.

 

Prescribing: PA may prescribe non-controlled and Schedule II - V medications included in PA’s scope of practice guidelines--PA applying for controlled substance prescriptive drug authority must have completed 60 hours of education in pharmacotherapeutics, and at least 15 hours of education in controlled substances.

 

Third Party Coverage for PA Services

 


Most private insurance companies cover physician services provided by PAs when the services are included as part of the physician’s bill. The majority of insurers want PA services billed under the physician’s name and/or provider number, but it is always best to check with the individual insurance company for specific information. Payments are made to the employer, not to the PA.

Medicare covers physician services provided by PAs in all settings for all patients at 85 percent of the physician’s fee schedule when services are billed under the PA’s own provider number. This includes hospitals (inpatient, outpatient, and emergency departments), nursing facilities, offices and clinics, and first assisting at surgery. Outpatient services provided in offices and clinics may be billed under the physician’s provider number according to Medicare’s "incident to” provision at 100 percent of the fee schedule only if (1) the physician is physically present on site when the PA provides care, (2) the physician treats all new Medicare patients (the PA may provide subsequent care), and (3) established Medicare patients with new medical problems are personally treated by the physician.I n South Carolina, PAs are Medicaid covered providers and are issued their own provider number similar to the Medicare program.

 

Compensation Facts and Figures

 

Benefits that employers typically provide PAs include funding for continuing medical education, paid vacation and sick leave, professional liability insurance, individual and family health insurance, license fees and professional dues, and pension or retirement funds.

 

A personalized salary profile specific to experience, geographic location, and specialty may be ordered by contacting the American Academy of Physician Assistants at (703) 836-2272.

 

Recruiting Physician Assistants

 


There are several ways to locate a PA who will benefit your practice or institution. Here are a few suggested strategies:


You can run an advertisement for your PA position through the SCAPA Career Center located on our website at the following link: http://phyast.sc.associationcareernetwork.com/Common/HomePage.aspx. Employment ads posted through this site are included in a national databank of PA positions, and an email of local positions is sent out twice each month to SCAPA members. Instructions for posting an ad can be found on the site, and there is a toll free number to call for assistance with posting the ad should you run into problems.

The Medical University of SC also has a PA Job Board and allows employers to enter job opportunities for its students and alumni via its website at http://academicdepartments.musc.edu/chp/current_students/. If you have any questions about the MUSC Job Board, contact Cami Meyer, M.Ed., Director of Student Life and Recruitment in the College of Health Professions at (843)792-1601, (866)690-2284, or meyec@musc.edu.


Contact the accredited physician assistant program at the Medical University of South Carolina in Charleston.The PA program posts job opportunities from employers who are interested in hiring new graduates.

Medical University of South Carolina

Physician Assistant Program

Gilbert Boissonneault, Clinical Coordinator

151-B Rutledge Ave

MSC 962

Charleston, SC 29425-0962

Phone: (843) 792-1913

Fax: (843) 792-0506

Email: gaboiss@musc.edu

MUSC Physician Assistant Program

 
Visit the PA Career Center. There are various PA employment resources.


Advertise in the Journal of the American Academy of Physician Assistants (JAAPA) which is circulated monthly to all graduate and student PAs.To place an ad, call (800) 983-7737.

Place an ad in AAPA News, a publication distributed twice a month to AAPA members. Call (800) 983-7737 to place an advertisement

Consider serving as a preceptor for physician assistant students. By mentoring students, physicians can assess the applicants to determine whose level of health care experience, clinical capabilities, and personality best fit their practice environment. Contact Mary Hewett at MUSC at the address listed above.

You may choose to contact a medical recruiter who places PAs. Be sure the recruiter has experience in PA placement and is knowledgeable about the PA profession.

 

For More Information

Go to For Employers on the AAPA website. This is an excellent tool with guidance on hiring, licensure, credentialing and creating an effective team practice.   




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