Katera Posted November 4, 2014 Hi everyone, I have been a practicing PA for over 20 years now and am ready to do something a little different. I want to go "full time" locums. What I am finding out though is that no one has been able to answer my questions concerning supervision. I am in Texas. So my questions are thus: 1. If an agency is sending you out to an UC to work for the weekend, how does the sup doc thing work? In Texas, to write narcotics you must have a sup doc of record listed ON the dps website. This takes a little time....but every locum agency here...and there are LOTS <I get 2-5 calls ever day>, states that DPS listed supervision is not required for locum work. One said until you are at a jobsite 3 weeks, it's is not required. I called the Medical Board...no help. I called TAPA.....0 help. TAPA referred me to a PA that is starting his own Locums agency........... Has anyone done locum work? If so how did it work for you, THANK YOU!!!!
Boatswain2PA Posted November 4, 2014 I have moved into strictly locums work, and I LOVE it for the scheduling and pay. For example, I worked a 72 hour shift over the past weekend in an incredibly slow place (about 1K visits per year), yet made great money, and was scheduled to be off for almost two weeks before doing another 72 hour shift in a much busier place (about 4K visits a year, but very high acuity). Got a call today from my scheduler asking me to do a 24 hour shift in another shop (over 5K visits a year) starting tomorrow morning at a rate that made me say "Yes....yes I'll take that shift!!!" They must reallllly need someone in the ED for that price!As to your specific question. In my state the requirement is for the supervisory agreement to be on file at medical board. In my area there is a large physician/PA/NP locums company, and then there is a group of PAs who run another locums company (who I work with). The large company has the PAs list the company's physician as the SP. I don't know how they get around the chart review requirements, my inclination is that they don't do it, but I could be wrong. But with this physician overhead, this company charges the local hospital much more than what we charge (which is still quite high). Our PA group puts more onus on the hospital by requiring a signed SP agreement for each PA who shows up. That's a little bit more work for the hospital (nothing compared to them doing credentialing for each of us), but it saves them a lot of money. So far, as our group has grown, the hospitals are liking us. If I were in your shoes I would do two things. #1: Go with the flow. If the heat comes down for some reason, it will probably come down on the group who you are working for and not yourself. #2: KEEP RECORDS of when you called the board and TAPA, who you talked to, and what they said. If they aren't telling you "you can't do this", then it's a gray zone.
Katera Posted November 6, 2014 Author ^^^ Thanks for the reply! I just want to do this right. One other question, do you work outside of your state? If so do you pay taxes of that state....or the one you are in? Thx!
MedicinePower Posted November 6, 2014 You may wish to consult with an attorney who specializes in PA and medical board licensing issues in your state in order to determine if you would be exposed to any liability or risk. Get they attorney's opinion in writing. This way you'll have someone to fall back on in case the medical board (or anyone else) starts asking questions.
Boatswain2PA Posted November 6, 2014 I don't work out of state, although our group is in discussions with one hospital right over the border in another state. I don't know the answer to the multi-state taxation, but I would assume yes.
problem child Posted November 13, 2014 Hi everyone, I have been a practicing PA for over 20 years now and am ready to do something a little different. I want to go "full time" locums. What I am finding out though is that no one has been able to answer my questions concerning supervision. I am in Texas. So my questions are thus: 1. If an agency is sending you out to an UC to work for the weekend, how does the sup doc thing work? In Texas, to write narcotics you must have a sup doc of record listed ON the dps website. This takes a little time....but every locum agency here...and there are LOTS <I get 2-5 calls ever day>, states that DPS listed supervision is not required for locum work. One said until you are at a jobsite 3 weeks, it's is not required. I called the Medical Board...no help. I called TAPA.....0 help. TAPA referred me to a PA that is starting his own Locums agency........... Has anyone done locum work? If so how did it work for you, THANK YOU!!!! if it is an urgent care center or clinic, it would be whoever the doc is that is medically responsible for the clinic. if there is no SP, they may need to get an NP. a PA CANNOT legally practice without an SP -- and it's your license! oh - and if you work out of your home state, you pay income taxes to both - the state you work in and your home state. beware with agencies bc a lot of them don't have a CLUE as to the legalities of hiring PAs. they just want their fee. this is information YOU MUST KNOW - it is YOUR PROFESSION and YOUR LICENSE! I've been on a rant about 1099s on another thread...an agency called me the other day and the first question I asked them (as always) was, is this a 1099 position? and they said yes, and I said, well, do you know that it is illegal to hire PAs as 1099s in the state of MA? and the agency was BASED in MA!!! they said, oh our legal dept researched this extensively and it's all worked out, so I asked to speak with someone in their legal dept to explain to me how they got around the fair labor practices drafted by the attorney general, and she fed me some gobble-di-gook, and I just said, well. based on what I know, it ain't legal. so thanks, but no thanks. they just want their fee. do your homework. don't get screwed.
Moderator LT_Oneal_PAC Posted November 13, 2014 Moderator if it is an urgent care center or clinic, it would be whoever the doc is that is medically responsible for the clinic. if there is no SP, they may need to get an NP. a PA CANNOT legally practice without an SP -- and it's your license! oh - and if you work out of your home state, you pay income taxes to both - the state you work in and your home state. beware with agencies bc a lot of them don't have a CLUE as to the legalities of hiring PAs. they just want their fee. this is information YOU MUST KNOW - it is YOUR PROFESSION and YOUR LICENSE! I've been on a rant about 1099s on another thread...an agency called me the other day and the first question I asked them (as always) was, is this a 1099 position? and they said yes, and I said, well, do you know that it is illegal to hire PAs as 1099s in the state of MA? and the agency was BASED in MA!!! they said, oh our legal dept researched this extensively and it's all worked out, so I asked to speak with someone in their legal dept to explain to me how they got around the fair labor practices drafted by the attorney general, and she fed me some gobble-di-gook, and I just said, well. based on what I know, it ain't legal. so thanks, but no thanks. they just want their fee. do your homework. don't get screwed. Would you please give your source where it says it's illegal to be 1099 in MA?
SoCalPA Posted November 16, 2014 OP is it true that Texas PAs can only write Schedule II if you are working and seeing the patient in the ED. Is that correct? Does the State Controlled Substance training override that? Just curious.
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