How Many Physician Assistants Can an MD Supervise?

Consistent with the ‘physician assistant’ title, PAs must practice with physician supervision. In reality, physician assistants may function almost autonomously in the everyday clinical role. But, a delegated MD must be available in some capacity, whether in-person or by phone, to help out should the need arise. The extent of required physician assistant oversight varies by state. One such component of state supervision requirements are regulations regarding the number of PAs a single physician may supervise simultaneously.

The American Academy of Physician Assistants suggests that state laws addressing the supervision of PAs avoid limiting the number of physician assistants that my be supervised by a single MD. Rather, the AAPA suggests this determination should be made at the practice level ‘according to the nature of services provided’. Most state laws, however, don’t follow suit.

Currently, 40 states delineate a maximum number of physician assistants a physician may supervise at one time. Those that do not limit the number of PAs an MD can supervise include Alaska, Arkansas, Maine, Massachusetts, Montana, New Mexico, North Carolina, North Dakota, Rhode Island, Tennessee, and Vermont.

The following table outlines the number of physician assistants a physician may supervise at one time in states with more restrictive oversight requirements.

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Why should physician assistants and physicians care about laws regulating the number of PAs an MD may supervise? First, utilizing physician assistants rather than hiring additional physicians is a cost-effective way for practice owners to expand services, volume, and ultimately revenue. Sctrict supervision laws restrict the growth of medical practices and have negative financial impact for practice owners. Second, for physician assistants, restrictive supervision laws limit job opportunities and earning potential. Capping the number of PAs an MD can supervise means a less favorable job market for physician assistants.

State regulations concerning physician supervision of PAs are anything but inconsequential and carry significant implications not only for physician assistant’s ability to practice but also for the financial stability of medical practices and their ability to deliver patient care.

How do physician supervision laws for PAs in your state compare?


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