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Somethings I don't understand about PA oversight and cert...


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So, this has bothered me all throughout PA school. My questions is...as PAs we are required to form that Doctor-PA relationship to work. But...where is this relationship documented? Like, is there some official registry in the state office where each practicing PA is listed and his supervising doctor is noted? How does the state ultimately have any assurance that we are working with a doctor and not simply (illegally) operating on our own?

 

Oh, and a second question...what is "credentialling"?

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You have to have an approved supervision contract to get your license in WV. So a doc has to sign, then a doc to sign you are of good character who isnt your employer, and then have an interview with the board of medicine. Then wait a year to write a prescription....YAY WVAPA....

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every state requires a delegation of services agreement with a doc to get you license. you need your license to get your rx rights.most states also require chart review of X % of charts and this is subject to audit so there must be some mechanism in place to show which charts were reviewed when.

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Credentialing is the process of granting privileges (permission), by the medical staff office, to work in the hospital or satellite location by review of application and supporting documents. During this process they review your educational background, license, letters of recommendation, documentation of prior procedural work (if needed), etc...Basically they make sure you're legit with a license and decide what you can and/or can not do before you can start working.

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Supervision:

 

Here... a "Practice Plan" must be submitted. This details a proposed working relationship between a PA and Physician.

 

This "practice plan" is a simple form that asks for basic demographical info (license #s, practice locations, alternate SPs) about the PA and SP. It also asked for a very brief description of the duties of the PA and the proposed plan for clinical supervision.

 

This plan CAN be denied. It usually takes about 3 days to get a plan approved/denied. The shortest time I had one approved was 3hrs. The longest time was 7 days because unbeknownst to me... the proposed SP had a poor practice record, had been sanctioned a few times, and they were hesitant to allow HIM to "supervise" anyone...

 

If the PA-C is attempting to practice physically separate from the SP’s primary place for meeting patients... or in a setting where the SP is present less than 25% of the practice time of the PA-C... then the PA-C needs to submit a "

Remote Site" practice plan.

Chart review:

 

Here... non certified PAs must have EVERY chart countersigned/reviewed. Certified PAs do not have any specific chart review.

 

 

Contrarian

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Some states also like Washington have different licensing boards for MD's and DO's with different restrictions on how you practice. I recently tried to add on a DO as an alternate for more surgical priviledges in the hosiptal but didn't because the board is so restrictive.

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In Pennsylvania, you have to first pass the PANCE, then apply for your state license. Then once you find a place of employment, you and your supervising physician must complete another form outlining your supervising physician agreement which outlines all of your roles and responsibilities. The DEA will not approve your prescriptive privileges until that agreement is approved by the state. Once you begin working, your supervising physician must sign off on your charts within a given period of time (7-10 days depending on the practice set-up). Each state is a little different in the process. Here is a link to the AAPA website that will provide more info for which particular state you are interested in: http://www.aapa.org/advocacy-and-practice-resources/state-government-and-licensing

 

Also, usually prior to graduation, most PA programs hold lectures outlining licensing procedures, PANCE procedures and DEA procedures.

 

Credentialing is a process that is usually specific to the site you work at, usually required at hospitals (at least it was for me). It involves background checks, drug screen, fingerprints, board/committee reviews, etc. It usually takes about 6-8 weeks once you have been given an offer of employment.

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