Hiring a Physician Assistant in South Carolina
A Guide for Physicians and Institutions
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
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 subspecialty area.
PAs routinely:
- Perform physical exams and take patient histories
- Order and interpret laboratory tests
- Manage and treat illnesses
- Assist in surgery
- Write prescriptions
- Provide health education and patient counseling
PA Cost- and Quality-Effectiveness
The federal Office of Technology Assessment found that patient satisfaction with PA care was high, and the care provided by PAs functioning within their training and expertise was equivalent to the quality of care provided by physicians for comparable services. According to 1998 data from the Medical Group Management Association, for every dollar of charges a primary care PA generates for the practice, the employer pays an average of 34 cents to employ the PA.
Additional benefits PAs may provide a practice include:
- Shorter waiting time for appointments
- Greater emphasis on disease prevention and patient education
- Ability to extend care into the community, including nursing homes, rural communities, and medically underserved areas
- Allowing physicians to focus on challenging cases instead of routine office visits
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 III - V 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 or more supervising physicians. For a copy of the Physician Assistant Practice Act follow this link: http://www.llr.state.sc.us/POL/Medical/PDF/PAAct.pdf
PA Education
PAs are trained in intensive medical education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. The typical PA student has a bachelor’s degree and four and a half years of health care experience prior to admission to a PA program. As of August 2005, 135 accredited PA programs were offered at medical schools, colleges and universities, teaching hospitals and through the Armed Forces.
PAs are educated in a medical model designed to complement physician training. Physician assistant students are taught, as medical students are, to diagnose and treat medical problems. Education consists of classroom and laboratory instruction (on average, 111 weeks) in the basic medical and behavioral sciences followed by 2,000 hours of clinical rotations in internal medicine, family medicine, surgery, pediatrics, ob/gyn, emergency medicine, and psychiatry. Students learn the team practice concept, which is to carefully gauge the extent and limits of their medical expertise and to consult their supervising physician when necessary.
Eighty percent of the PA programs award master’s degrees. The only accredited PA program in South Carolina is at the Medical University of South Carolina in Charleston. MUSC confers a Masters of Science in Physician Assistant Studies.
PA Credentials
After graduation, PAs in South Carolina, as in nearly all states, 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 six years. PAs do not have specialty boards, but must apply for and receive state licensure before practicing.
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. The law is also available on the following link: http://www.llr.state.sc.us/POL/Medical/PDF/PAAct.pdf.
South Carolina Board of Medical Examiners
PO Box 11289
Columbia, SC 29211-1289
803/896-4500
A brief summary of the state law follows:
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: Physician must be on-site 75% of the time each month. Board approval required for PA utilization at practice site different from that of supervising physician, may require 6 months previous experience.
Prescribing: PA may prescribe non-controlled and Schedule III - V medications included in PA’s scope of practice guidelines
Compensation Facts and Figures
PA salaries vary depending on experience, specialty, geographic location, and whether call is taken. According to the 2007 AAPA Physician Assistant Cesnsus Report, the national median total annual income from primary employer for PAs who work at least 32 hours per week for their primary employer and who are not self-employed is $82,223; the mean is $86,214. The comparable figures for PAs who graduated in 2006 are $71,825 and $73,013, respectively. The mean total income for clinically practicing PAs in
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/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
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. In South Carolina, PAs are Medicaid covered providers and are issued their own provider number similar to the Medicare program.
AMA Guidelines for Physician-Physician Assistant Practice
- 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.
Adopted by the AMA House of Delegates, June 1995.
Recruiting Physician Assistants
There are several ways to locate a PA who will benefit your practice or institution. Here are a few suggested strategies:
- Contact the state PA association, the South Carolina Academy of Physician Assistants (SCAPA). Job listings are published in their newsletter and posted on the SCAPA website. This is a free service to all Physicians and practice managers in South Carolina. On the SCAPA website there is a link to advertise with the national PA organization, the American Academy of Physician Assistants (AAPA).
SCAPA
PO Box 2054
Lexington, SC 29071
(803)356-6809
FAX (803) 356-6826
www.scapapartners.org
E-mail: scapa@sc.rr.com
- 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
Clinical Coordinator
PO Box 250856
Charleston, SC 29425
(843) 792-8885
FAX (843) 792-0506
- Click on the PA Job Link icon found on the Employment Opportunities page of the SCAPA website, for the online service that matches PA job seekers and employers.
- Or visit the “Employment and Employer’s Guide” on the menu bar of the American Academy of Physician Assistants (AAPA) website, www.aapa.org. 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.
Further Information
More detailed information is contained in the AAPA publications Hiring a Physician Assistant and Contacts & Contracts. Copies may be ordered at www.aapa.org/aapastore. The following organizations may be contacted for specific questions.
South Carolina Academy of Physician Assistants
PO Box 2054
Lexington, SC 29071
(803)356-6809
FAX (803) 356-6826
www.scapapartners.org
E-mail: scapa@sc.rr.com
Physician Assistant Program
Mary Hewett, Clinical Coordinator
PO Box 250856
Charleston, SC 29425
(843) 792-8885
FAX (843) 792-0506
www.musc.edu/pa_program
South Carolina State Board of Medical Examiners
PO Box 11289
Columbia, SC 29211-1289
(803) 896-4500
National Commission on the Certification of Physician Assistants
12000 Findley Road, Suite 200
Duluth, GA 30097
(678) 417-8100
Fax (678) 417-8135
American Academy of Physician Assistants
950 North Washington Street
Alexandria, VA 22314-1552
(703) 836-2272