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Laws regarding SPs


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I realize it probably varies by state, but I am just curious about general regulation regarding who can be your SP. I know some states have laws about the number of PAs a doc can supervise/what their requirements are but my specific questions are:

 

Are there laws written about the relation the PA and doc can have? Can a family member be your SP? I know a PA who works at her DO husband's practice but I don't know if he's actually her SP on the record.

 

What happens if your SP dies suddenly or quits or looses their license or decides they don't want to be your SP or any of the probably hundreds of other reasons that could lead to sudden lack of a SP? Do most PAs have multiple SPs on record incase this happens? Is there a grace period to find a new one or something? I remember reading that if a PA is going to own a practice it is important to have two SPs...

 

Thanks! I did do a search of the forum and couldn't find this info so I apologize if it's been discussed previously.

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I realize it probably varies by state, but I am just curious about general regulation regarding who can be your SP. I know some states have laws about the number of PAs a doc can supervise/what their requirements are but my specific questions are:

 

Are there laws written about the relation the PA and doc can have? Can a family member be your SP? I know a PA who works at her DO husband's practice but I don't know if he's actually her SP on the record.

 

What happens if your SP dies suddenly or quits or looses their license or decides they don't want to be your SP or any of the probably hundreds of other reasons that could lead to sudden lack of a SP? Do most PAs have multiple SPs on record incase this happens? Is there a grace period to find a new one or something? I remember reading that if a PA is going to own a practice it is important to have two SPs...

 

Thanks! I did do a search of the forum and couldn't find this info so I apologize if it's been discussed previously.

 

I can't imagine any law that would prevent a relative from being your SP along as you meet the standard rules about SPs.

 

Having a lone SP, there is always that risk. If they get hit by a car and killed, then your job immediately ends . . . in that millisecond . . . unless you have another SP. Some of us who are vulnerable have done things like buying a life/disability insurance policy on your SP. If they are incapacitated then the policy would pay you a year's salary so you have time to find that other position. I haven't purchased that policy yet (waiting on my cash flow to be better) but I will because my entire practice would fold. Now as my other form of "insurance" is that I have at least 1 SP in the wings who said that they would step in and be my SP . . . however, the devil would be in the details (how much money they would want).

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I can't imagine any law that would prevent a relative from being your SP along as you meet the standard rules about SPs.

 

Having a lone SP, there is always that risk. If they get hit by a car and killed, then your job immediately ends . . . in that millisecond . . . unless you have another SP. Some of us who are vulnerable have done things like buying a life/disability insurance policy on your SP. If they are incapacitated then the policy would pay you a year's salary so you have time to find that other position. I haven't purchased that policy yet (waiting on my cash flow to be better) but I will because my entire practice would fold. Now as my other form of "insurance" is that I have at least 1 SP in the wings who said that they would step in and be my SP . . . however, the devil would be in the details (how much money they would want).

 

On average, how long does the process of securing a SP take? Longer than a few days?

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On average, how long does the process of securing a SP take? Longer than a few days?

 

Because I started my own practice, it took me six years to secure a SP. I met with about 10 along the way. However, my old SP is willing to step right in, just that he may argue for more money than I would want to pay. My other options are abandoning my practice and selling out to a hospital group that would supply a SP.

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The PA who works with a lone physician is at risk of losing their job immediately upon the SPs death, resignation, firing, etc. It is one of the issues that should be of supreme importance to PAs when securing a job. When, interviewing, ask who the backup physician is for the practice, and if there is none, ask if they have a list of physicians that could be called in to provide the supervision. Those of us who work in rural practices (like me) are vulnerable since finding a physician who could step in is no easy task. Just like JMJ11 states, it can take a long time to find a substitute.AAPA website can be referenced and you will find all the state laws listed and the scope of practice issues, delegation of prescription privileges, etc. The SP issue is something that needs to be addressed by the AAPA and state chapters to open up our practice laws and do away with the supervision language. It does not help our patients to lose their provider because the SP suddenly leaves. Is it possible with the ACA now in place and continuing on the implementation timeline, that AAPA will step up to the plate and start lobbying the CMS and HHS Sebelius to correct our place in medicine? I think it will take an act of federal legislation to over come the dissent we will experience when this happens..if it happens.

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How about for PAs who are in a more traditional (i.e., don't own the practice) situation? Let's say they work in a family medicine group practice, the SP gets hit by a meteor, so the PA needs a new SP. Should that PA expect a long drawn-out period of getting one of the other MDs in the group to sign on as SP? That example would likely be a 'best case' scenario I would think.

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How about for PAs who are in a more traditional (i.e., don't own the practice) situation? Let's say they work in a family medicine group practice, the SP gets hit by a meteor, so the PA needs a new SP. Should that PA expect a long drawn-out period of getting one of the other MDs in the group to sign on as SP? That example would likely be a 'best case' scenario I would think.

 

It is too complicated to figure out for each situation, but in most, if it is a large group, another physician would step in.

 

I actually faced this situation about 15 years ago. I joined a IM group of about 7 physicians. My SP was a rheumatologist. To add an interesting drama to this story, she was caught having sex in the office with one of the other docs. All hell broke loose as they were both married with families. I came to work one morning to find out that she was in ICU with a self-inflicted overdose and at that time they didn't think she would survive.

 

Now another doc in the group, a nephrologist immediately became my SP. Papers were filed that day. But the strange thing, and the reason I left after a few months, was that he wanted me to take over the rheumatologist's practice in her absence. It would be deeply frowned up on and actually not a good model for the SP to be on one specialty and you another (working outside the SP's scope of practice). If I ever went to court it would have been a nightmare. So I immediately started looking for a new position.

 

But in a family practice group, usually there is a back up SP for when the primary SP is gone. It would be a natural transition for that back up SP step up to the plate and be the primary SP. But you could run into one of these Napa-phobic (irrational fear of NPs and PAs), where the back up SP refused to become primary.

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It is too complicated to figure out for each situation ... [brevity edit]...

 

... [brevity edit]... But in a family practice group, usually there is a back up SP for when the primary SP is gone. It would be a natural transition for that back up SP step up to the plate and be the primary SP. But you could run into one of these [closeted NPP HATERS or ] Napa-phobic (irrational fear of NPs and PAs), where the back up SP refused to become primary.

 

This happens often...

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How about for PAs who are in a more traditional (i.e., don't own the practice) situation? Let's say they work in a family medicine group practice, the SP gets hit by a meteor, so the PA needs a new SP. Should that PA expect a long drawn-out period of getting one of the other MDs in the group to sign on as SP? That example would likely be a 'best case' scenario I would think.
'

in most group practices the other docs are already listed as alternate sp's so there is no problem if the primary leaves/dies/etc.

getting a new sp credentialed can vary from days to months. some states require a written test, CV review, etc

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All great info and interesting scenarios, thanks! Am I correct in assuming that when the SP and PA are both hospital employees (as seems to be the case more and more often) that it would be in the hospital's best interest to make sure there is a backup SP ready or on the books...? And any hospital of decent size should have plenty of docs ready/willing to SP...

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All great info and interesting scenarios, thanks! Am I correct in assuming that when the SP and PA are both hospital employees (as seems to be the case more and more often) that it would be in the hospital's best interest to make sure there is a backup SP ready or on the books...? And any hospital of decent size should have plenty of docs ready/willing to SP...

yup. although docs who are going to be sp's typically are in the same group/specialty.

some states require that docs supervise pa's within the same specialty( as in an em doc couldn't be sp for a rheumatology pa practicing rheumatology))

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