Prior to these amendments, physicians and PAAs were required to conclude a „delegation of service agreements,“ in particular the delegation of medical services that a PA could provide. If several doctors supervise the AP – z.B in a group office or hospital – each had to either sign the delegation of service agreements or create one. The law also describes the specific and limited means by which physicians can carry out their supervisory duties; These include diagram revisions, reallocation data sets, patient-specific minutes and medical record review meetings. (iii) The supervisory physician and surgeon check a sample of at least 10 medical records per month, at least ten months per year, combining the counter-signature mechanism described in clause (i) and the medical record verification mechanism described in paragraph ii above. Gov. Brown has signed SB 337 (Pavley, D-Agoura Hills), sponsored by the California Academy of Physician Assistants, and requires the medical records of each patient treated by a medical assistant (PA) to identify the physician responsible for monitoring this PA for this episode of patient care. Hospitals must apply guidelines and procedures and train all institutions that are implemented to ensure that this requirement is met. The law will come into force on January 1, 2016. The new law also provides that „nothing in the regulations requires a physician and surgeon to verify or contrasign a patient`s medical record treated by a medical assistant, unless the practice agreement requires.“ bus. Code 3502 (c), amended by SB 697 (valid January 1, 2020). To this end, the amended Section 3502.3 of the Professional and Professional Code provides that the practice agreement must address „policies and procedures to ensure adequate follow-up of the medical assistant, including, but not limited to, adequate communication, availability, consultations and transfers between a physician and a surgeon and the medical assistant during the provision of medical services.“ bus. Code No. 3502.3 (a) (1) (B), amended by SB 697 (valid January 1, 2020).
In other words, while the transfer of service agreements, such as contracts, was directly between each father and his or her own supervisory physician or supervisory physician, the new practice agreement is more like a standardized procedure for advanced established nurses (APRN). As standardized procedures also apply to the entire organized health system practical agreements that allow any physician in the system to monitor each PA subject to the practice agreement. A PaPa can evaluate a patient in agreement with PaPa`s service delegation. However, only a physician has the right to recommend the medical use of marijuana in accordance with Section 11362.5. Whichever monitoring mechanism is chosen, the supervisory physician must choose to verify which cases, after diagnosis, problem, treatment or assessment procedure, pose the greatest risk to the patient. No no. The attending physician should not be on site, but must be available at all times, personally or electronically, when the AP is caring for patients. The decision maintains the requirement that all PAs be supervised by a physician, but the requirement for a practice agreement or transfer of service agreements is removed. In motivating the adoption of this decision, the Department stated in its guide that the requirement for a written monitoring agreement with a supervisory physician „makes it difficult and infirable where and how the Pa can exercise, and will prevent the Pa, despite its jurisdiction to provide different medical services, from responding urgently where they are most needed.“ The state`s regulatory landscape appears to be changing to allow for closer monitoring of the PA and to reduce the administrative burden on monitoring PA clinical practices.