Current through Register Vol. 49, No. 9, September, 2024
PHYSICIAN DELEGATION REGULATION
Act 472 of the General Assembly of the State of Arkansas, as of
the year 2009, authorized Physicians to delegate the performance of certain
medical practices or tasks to qualified and properly trained employees
(commonly referred to as medical assistants), who are not licensed or otherwise
specifically authorized by Arkansas law to perform the practice or task. This
Regulation will set forth standards to be met and the procedures to be followed
by the Physician when delegating to employees.
Definitions for Purposes of this Regulation:
1.. "Physician" means an individual licensed
by the Arkansas State Medical Board to practice medicine. In the State of
Arkansas.
2. "Medical Practice"
means those tasks or functions that are delegated to a qualified and properly
trained employee, including the administration of drugs, pursuant to Act 472 of
2009 and this Regulation.
3.
"Delegate" means to authorize a qualified and properly trained employee to
perform a medical practice that does not conflict with a provision of the
Arkansas Code that specifically authorizes an individual to perform a
particular practice.
4.
"Supervision" means the act by a Physician in directing and overseeing an
employee who performs a delegated medical practice.
5. "Medical Assistant" means an employee of a
Physician who has been delegated medical practices or tasks, and who has not
been licensed by or specifically authorized to . perform the practice or task
pursuant to other provisions of Arkansas law.
Section 1. General Provisions
A. The delegating Physician remains
responsible for the acts of the employee performing the delegated medical
practice;
B. The employee
performing the delegated medical practice shall not be represented to the
public as a licensed physician) licensed nurse, licensed physician's assistant,
or other licensed healthcare provider; and
C. Medical practices delegated pursuant to
this statute and regulation shall be performed under the physician's
supervision.
Section 2.
Procedures for Delegating a Medical Practice
A. Prior to delegating a medical practice or
task, the physician shall determine the following:
1) That the medical practice or task is
within that Physician's authority to perform;
2) That the medical practice or task is
indicated for the patient;
3) The
appropriate level of supervision for the Physician to exercise while the
medical practice or task is being performed;
4) That the person to whom the medical
practice or task is being delegated is qualified and properly trained to
perform the medical practice or task; and
5) That the medical practice is one that can
be appropriately delegated when considering the following factors:
i. That the medical practice can be performed
without requiring the exercise of judgment based on medical
knowledge;
ii. That the results of
the medical practice are reasonably predictable;
iii. That the medical practice can be safely
performed according to exact, unchanging directions;
iv. That the medical practice can be
performed without the need for complex observations or critical decisions;
and.
v. That the medical practice
can be performed without repeated medical assessments.
Section 3. Additional
Requirements for Delegating the Administration of Drugs
A. A Physician may only delegate the
administration of drugs that do not require substantial, specialized judgment
and skill based on knowledge and application of the principles of biological,
physical, and social sciences.
B.
Administration of drugs, delegated pursuant to this Regulation, shall only be
permissible within the physical boundaries of the delegating physician's
offices;
C. The Physician shall
evaluate the acuity of the patient and make a determination that delegation is
appropriate;
D. The Physician shall
determine the competency of the person to whom the administration of drugs is
being delegated through training and experience, including the physician's
personal observation.
Section
4. Prohibitions
A. A physician
shall not transfer his or her responsibility for supervising an unlicensed
person in the performance of a delegated medical practice except to another
physician who has knowingly accepted that responsibility;
B. A physician shall not authorize or permit
an unlicensed person to whom a medical practice is delegated to delegate the
performance of that practice to another person;
C. A physician shall not delegate to an
unlicensed person the administration of anesthesia;
D. A physician shall not delegate a medical
practice that is not within the authority of that physician or is beyond the
physician's training, expertise, or normal course of practice; and
E. A physician shall not delegate a medical
practice to an unlicensed person if the practice is beyond that person's
competence.
