December 22, 2021 – Commissioner’s order: Out of state licensed providers should read this memo from DPH Commissioner Manisha Juthani, MD and note the list of professions authorized by the Commissioner’s order

Physicians Supervising Physician Assistants

 

Registration/Documentation

 

Connecticut licensed physicians who supervise physician assistants are not required to be registered as a supervising physician with the Department.  Physicians are not required to notify the Department of a change in a supervisory relationship with physician assistants. 

 

Each physician assistant practicing in Connecticut or participating in a resident physician assistant program shall have a clearly identified supervising physician who maintains the final responsibility for the care of patients and the performance of the physician assistant. 

 

A physician may function as a supervising physician for as many physician assistants as is medically appropriate under the circumstances, provided the supervision is active and direct, and the physician is supervising not more than six full-time physician assistants concurrently, or the part-time equivalent thereof.

 

Supervision in Hospital Settings

 

Supervision in hospital settings means the exercise by the supervising physician of oversight, control and direction of the services of a physician assistant. Supervision includes but is not limited to: Continuous availability of direct communication either in person or by radio, telephone or telecommunications between the physician assistant and the supervising physician; active and continuing overview of the physician assistant's activities to ensure that the supervising physician's directions are being implemented and to support the physician assistant in the performance of his or her services; personal review by the supervising physician of the physician assistant's practice on a regular basis as necessary to ensure quality patient care in accordance with a written delegation agreement; review of the charts and records of the physician assistant on a regular basis as necessary to ensure quality patient care;  delineation of a predetermined plan for emergency situations; and designation of an alternate licensed physician in the absence of the supervising physician. 

 

Supervision in Other Settings

 

Supervision in settings other than hospital settings means the exercise by the supervising physician of oversight, control and direction of the services of a physician assistant. Supervision includes, but is not limited to: Continuous availability of direct communication either in person or by radio, telephone or telecommunications between the physician assistant and the supervising physician; active and continuing overview of the physician assistant's activities to ensure that the supervising physician's directions are being implemented and to support the physician assistant in the performance of his or her services; at a facility or practice location where the physician assistant or supervising physician performs services, in accordance with a written delegation agreement; review of the charts and records of the physician assistant on a regular basis as necessary to ensure quality patient care and written documentation by the supervising physician of such review at the facility or practice location where the physician assistant or supervising physician performs services; delineation of a predetermined plan for emergency situations; and designation of an alternate licensed physician in the absence of the supervising physician.  

 

Alternate Supervisors  

 

Other physicians may participate in the day-to-day clinical oversight of physician assistants provided the identified supervising physician (or alternate as applicable): (1) maintains  responsibility for the oversight, control and direction of the services provided by the physician assistant as well as the final responsibility for the care of patients and the performance of the physician assistant and (2) performs the supervision as required above.

The law requires the designation of an alternate licensed physician in the absence of the identified supervising physician.  The term “absence” is not defined. 

 

It is the Department’s expectation that the alternate would be required at such times that the supervising physician is unable to (1) maintain responsibility for the oversight, control and direction of the services provided by the physician assistant as well as the final responsibility for the care of patients and the performance of the physician assistant and (2) perform the supervision as required above (for example, personal review by the supervising physician of the physician assistant's practice through a face-to-face meeting at least weekly or more frequently as necessary; and review of the charts and records of the physician assistant on a regular basis).

 

An alternate supervising physician would need to be designated for an anticipated absence.  Supervising physicians should also have plans in place to ensure that an alternate supervising physician is designated in the event of an unplanned absence.