CAFP recently wrote a letter to Director of California Department of Health Services Sandra Shewry to ask for resolution of conflicting requirements for supervising physicians to countersign physician assistant orders.

On the one hand, CAFP noted, the Business and Professions Code allows PAs to perform medical services set forth in Medical Board of California regulations authorizing them to perform many medical services under physician supervision. These regulations permit physicians to countersign at least 10 percent of a PA’s patient medical records within 30 days, when the PA functions pursuant to protocols adopted by the supervising physician. Only in the case of a PA issuing an order for a Schedule II drug is a physician countersignature required within seven days.

On the other hand, separate Medi-Cal regulations issued by the Department of Health Services require all Medi-Cal patient records to be countersigned by the supervising physician within seven days. At a time in which increased workload, under-payment for services and declining medical student interest has stretched California’s primary care physician workforce to the breaking point, CAFP argued that California can ill-afford the inefficient use of any member of the primary health care delivery team, unless such reduced efficiency increases patient safety or improves health outcomes.

For more information, e-mail Tom Riley at tomriley@calcapitol.com.