Scope of Supervision Required

(1) All professional activities of a physician assistant must be supervised by a supervising physician licensed by the Massachusetts Board of Registration in Medicine pursuant to 243 CMR 2.08: Physician Assistants. A "supervising physician", for purposes of 263 CMR 5.04, shall mean a physician who holds an unrestricted full license issued by the Massachusetts Board of Registration in Medicine. (2) A supervising physician may use a physician assistant to assist him or her in the process of gathering data necessary to make decisions and institute patient care plans. A physician assistant shall not, however, supplant a licensed physician as the principal medical decision-maker. (3) A supervising physician shall afford supervision adequate to ensure all of the following: (a) The physician assistant practices medicine in accordance with accepted standards of medical practice. 263 CMR 5.04(1) does not require the physical presence of the supervising physician in every situation in which a physician assistant renders medical services. (b) The physician assistant, except in life-threatening emergencies where no licensed physician is available, informs each patient that he or she is a physician assistant and that he or she renders medical services only under the supervision of a licensed physician. (c) The physician assistant wears a name tag which identifies him or her as a physician assistant. (d) The supervising physician reviews diagnostic and treatment information, as agreed upon by the supervising physician and the physician assistant, in a timely manner consistent with the patient's medical condition. (e) On follow-up care, hospital visits, nursing home visits, attending the chronically ill at home, and in similar circumstances in which the supervising physician has established a therapeutic regimen or other written protocol, the physician assistant checks and records a patient's progress and reports the patient's progress to the supervising physician. Supervision is adequate under 263 CMR 5.04(3)(e) if it permits a physician assistant who encounters a new problem not covered by a written protocol or which exceeds established parameters to initiate a new patient care plan and consult with the supervising physician. (f) In an emergency, the physician assistant renders emergency medical services necessary to avoid disability or death of an injured person until a licensed physician arrives. (g) When a supervising physician is unable or unavailable to be the principal medical decision-maker, another licensed physician must be designated to assume temporary supervisory responsibilities with respect to the physician assistant. The name and scope of responsibility of the physician providing such temporary supervision must be readily ascertainable from records kept in the ordinary course of business which are available to patients. The supervising physician(s) of record is ultimately responsible for ensuring that each task performed by a physician assistant is properly supervised.