(1) All professional activities of a
physician assistant must be supervised by a supervising physician licensed by
the Massachusetts Board of Registration in Medicine pursuant to
243 CMR
2.08: Physician Assistants.
A "supervising physician", for purposes of 263 CMR 5.04, shall mean a physician
who holds an unrestricted full license issued by the Massachusetts Board of
Registration in Medicine.
(2) A
supervising physician may use a physician assistant to assist him or her in the
process of gathering data necessary to make decisions and institute patient
care plans. A physician assistant shall not, however, supplant a licensed
physician as the principal medical decision-maker.
(3) A supervising physician shall afford
supervision adequate to ensure all of the following:
(a) The physician assistant practices
medicine in accordance with accepted standards of medical practice. 263 CMR
5.04(1) does not require the physical presence of the supervising physician in
every situation in which a physician assistant renders medical
services.
(b) The physician
assistant, except in life-threatening emergencies where no licensed physician
is available, informs each patient that he or she is a physician assistant and
that he or she renders medical services only under the supervision of a
licensed physician.
(c) The
physician assistant wears a name tag which identifies him or her as a physician
assistant.
(d) The supervising
physician reviews diagnostic and treatment information, as agreed upon by the
supervising physician and the physician assistant, in a timely manner
consistent with the patient's medical condition.
(e) On follow-up care, hospital visits,
nursing home visits, attending the chronically ill at home, and in similar
circumstances in which the supervising physician has established a therapeutic
regimen or other written protocol, the physician assistant checks and records a
patient's progress and reports the patient's progress to the supervising
physician. Supervision is adequate under 263 CMR 5.04(3)(e) if it permits a
physician assistant who encounters a new problem not covered by a written
protocol or which exceeds established parameters to initiate a new patient care
plan and consult with the supervising physician.
(f) In an emergency, the physician assistant
renders emergency medical services necessary to avoid disability or death of an
injured person until a licensed physician arrives.
(g) When a supervising physician is unable or
unavailable to be the principal medical decision-maker, another licensed
physician must be designated to assume temporary supervisory responsibilities
with respect to the physician assistant. The name and scope of responsibility
of the physician providing such temporary supervision must be readily
ascertainable from records kept in the ordinary course of business which are
available to patients. The supervising physician(s) of record is ultimately
responsible for ensuring that each task performed by a physician assistant is
properly supervised.
