CODE OF VIRGINIA

SUPERVISION OF ASSISTANTS BY LICENSED PHYSICIAN, OR PODIATRIST; SERVICES THAT
MAY BE PERFORMED BY ASSISTANTS; RESPONSIBILITY OF LICENSEE; EMPLOYMENT OF
ASSISTANTS (§ 54.1-2952)

A. A physician or a podiatrist licensed under this chapter may supervise
physician assistants and delegate certain acts which constitute the practice of
medicine to the extent and in the manner authorized by the Board. The physician
shall provide continuous supervision as required by this section; however, the
requirement for physician supervision of physician assistants shall not be
construed as requiring the physical presence of the supervising physician during
all times and places of service delivery by physician assistants. Each team of
supervising physician and physician assistant shall identify the relevant
physician assistant’s scope of practice, including the delegation of
medical tasks as appropriate to the physician assistant’s level of
competence, the physician assistant’s relationship with and access to the
supervising physician, and an evaluation process for the physician
assistant’s performance.Physician assistants appointed as medical
examiners pursuant to § 32.1-282 shall be under the continuous supervision of a
licensed doctor of medicine or osteopathic medicine who has been appointed to
serve as a medical examiner pursuant to § 32.1-282.No licensee shall be allowed
to supervise more than six physician assistants at any one time.Any professional
corporation or partnership of any licensee, any hospital and any commercial
enterprise having medical facilities for its employees which are supervised by
one or more physicians or podiatrists may employ one or more physician
assistants in accordance with the provisions of this section.Activities shall be
delegated in a manner consistent with sound medical practice and the protection
of the health and safety of the patient. Such activities shall be set forth in a
practice supervision agreement between the physician assistant and the
supervising physician or podiatrist and may include health care services which
are educational, diagnostic, therapeutic, preventive, or include treatment, but
shall not include the establishment of a final diagnosis or treatment plan for
the patient unless set forth in the practice supervision agreement. Prescribing
or dispensing of drugs may be permitted as provided in § 54.1-2952.1. In
addition, a licensee is authorized to delegate and supervise initial and ongoing
evaluation and treatment of any patient in a hospital, including its emergency
department, when performed under the direction, supervision and control of the
supervising licensee. When practicing in a hospital, the physician assistant
shall report any acute or significant finding or change in a patient’s
clinical status to the supervising physician as soon as circumstances require
and shall record such finding in appropriate institutional records. The
physician assistant shall transfer to a supervising physician the direction of
care of a patient in an emergency department who has a life-threatening injury
or illness. Prior to the patient’s discharge, the services rendered to
each patient by a physician assistant in a hospital’s emergency department
shall be reviewed in accordance with the practice agreement and the policies and
procedures of the health care institution. A physician assistant who is employed
to practice in an emergency department shall be under the supervision of a
physician present within the facility.Further, unless otherwise prohibited by
federal law or by hospital bylaws, rules, or policies, nothing in this section
shall prohibit any physician assistant who is not employed by the emergency
physician or his professional entity from practicing in a hospital emergency
department, within the scope of his practice, while under continuous physician
supervision as required by this section, whether or not the supervising
physician is physically present in the facility. The supervising physician who
authorizes such practice by his physician assistant shall (i) retain exclusive
supervisory control of and responsibility for the physician assistant and (ii)
be available at all times for consultation with both the physician assistant and
the emergency department physician. Prior to the patient’s discharge from
the emergency department, the physician assistant shall communicate the proposed
disposition plan for any patient under his care to both his supervising
physician and the emergency department physician. No person shall have control
of or supervisory responsibility for any physician assistant who is not employed
by the person or the person’s business entity.

B. No physician assistant shall perform any delegated acts except at the
direction of the licensee and under his supervision and control. No physician
assistant practicing in a hospital shall render care to a patient unless the
physician responsible for that patient has signed the practice agreement,
pursuant to regulations of the Board, to act as supervising physician for that
physician assistant. Every licensee, professional corporation or partnership of
licensees, hospital or commercial enterprise that employs a physician assistant
shall be fully responsible for the acts of the physician assistant in the care
and treatment of human beings.

C. Notwithstanding the provisions of § 54.1-2956.8:1, a licensed physician
assistant who (i) is working under the supervision of a licensed doctor of
medicine or osteopathy specializing in the field of radiology, (ii) has been
trained in the proper use of equipment for the purpose of performing radiologic
technology procedures consistent with Board regulations, and (iii) has
successfully completed the exam administered by the American Registry of
Radiologic Technologists for physician assistants for the purpose of performing
radiologic technology procedures may use fluoroscopy for guidance of diagnostic
and therapeutic procedures.

HISTORY: 1973, c. 529, §§ 54-281.4, 54-281.5; 1975, cc. 508, 565; 1985, c.
316; 1988, c. 765; 1992, c. 793; 1996, c. 779; 2000, cc. 467, 497; 2002, c. 387;
2005, c. 662; 2008, c. 281; 2012, c. 81; 2014, c. 89; 2015, c. 107; 2016, c.
450.