You asked for information on a possible conflict between statutes governing supervision of physician assistants.

PA 90-211 established a process and standards for licensing physician assistants (PAs) and authorized them to prescribe drugs (CGS § 20-12a -12h). (Prior law had defined physician assistants but did not license them. ) The act specifies that each physician assistant must have a clearly identified “supervising physician,” who has final responsibility for patient care and the PA's performance. A “supervising physician” is a state-licensed physician who is registered with the Department of Public Health (DPH) and assumes responsibility for the supervision of services rendered by a PA (CGS § 20-12a(6)).

“Supervision” means the oversight, control, and direction of a PA's services and includes:

1. continuous availability of direct communication either in person or by radio, telephone, or telecommunications (emphasis added) between the PA and the supervising physician;

2. active and continuing overview of the PA's activities to ensure that the supervising physician's directions are being implemented and to support the PA in performing his services;

3. personal review of the PA's practice at least weekly or more frequently if necessary;

4. regular review of the PA's charts and records; (5) having a predetermined plan for emergencies; and (6) designation of an alternate supervising physician in the case of absences (§ 20-12a(7)).

PA 97-213 amended the PA law to allow a physician to supervise up to six full-time PAs concurrently, or the equivalent part-time number, if medically appropriate. (Prior law limited a physician to concurrently supervising no more than two full-time PAs or the part-time equivalent. ) This act specifies that the supervision must be “active and direct, and at the specific location in which the PA is practicing” (§ 20-12c(b)).

DPH's application form for “Registration as a Supervising Physician” (attached) repeats the language of § 20-12c(b) that the supervision must be active and direct, and at the specific location of the PA's practice.

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