During the 2015 legislative session of the Kentucky General Assembly, HB 258, was approved by lawmakers and signed by Governor Beshear.  This legislation amends KRS 311.854 to allow a physician to supervise up to four physician assistants (“PAs”) at the same time. This amended regulation goes into effect on June 24, 2015.

PAs perform a wide range of duties, including providing routine care, treating acute and chronic illnesses, managing hospital inpatients, performing minor surgeries, and assisting during major surgeries. To a large degree, supervising physicians are granted the flexibility to delegate tasks to PAs and determine appropriate supervision methods, but state scope-of-practice laws sometimes limit physicians’ authority.

In addition, a physician must file an application, and be approved, with the Kentucky Board of Medical Licensure (“KBML”) before supervising a PA. This process must be completed for each PA that is supervised. As part of this application process, a physician must provide a statement of assurance, therefore placing himself/herself as being responsible for the actions of the PA. Failure to obtain board approval as a supervising physician or failure to comply with the requirements of KRS 311.840 to 311.862 or related administrative regulations will be considered unprofessional conduct and will subject the physician to disciplinary action by the board. This may include revocation, suspension, restriction, or placing on probation the supervising physician’s right to supervise a physician assistant.

It is also important to remember that the application process requires specific descriptions of the scope of practice of the PA. If for any reason, the scope of practice changes, the physician is required to supplement the application and receive approved for the expansion/change in scope. The KBML has the regulatory authority to either approve the scope of practice or place limitations on the methods of supervision required by the physician.

The task of complying with the regulatory responsibilities of supervision while simultaneously supervising multiple PAs can become onerous. Obtaining guidance before assuming these important supervisory responsibilities is a crucial step to take in order to help alleviate any obstacles with these tasks.