Florida Board of Medicine Promulgates an Opinion on Scope of Services a Physician Assistant may Perform

In the Florida Board of Medicine Final Order In Re Petition for Declaratory Statement Timothy Hipp, M.D., dated June 11, 2012, the Board of Medicine opines that Dr. Hipp, a board certified general surgeon with a sub specialized bariatric surgical practice, may allow a physician assistant working under Dr. Hipp’s indirect supervision to perform Lap-Band adjustments in an outpatient clinic setting under the circumstances set forth in the factual section of the Final Order. Such facts include that prior to performing any Lap-Band adjustments under Dr. Hipp’s indirect supervision, Dr. Hipp will require his Physician Assistants to observe 50 Lap-Band adjustments and perform another 50 under direct supervision.

In reaching its decision, the Florida Board of Medicine cites Florida Administrative Code Rules 64B8-30.012(1) and (2), which read as follows:

"(1) A supervising physician shall delegate only tasks and procedures to the physician assistant which are within the supervising physician’s scope of practice. The physician assistant may work in any setting that is within the scope of practice of the supervising physician’s practice. The supervising physician’s scope of practice shall be defined for the purpose of this section as "those tasks and procedures which the supervising physician is qualified by training or experience to perform."

(2) The decision to permit the physician assistant to perform a task or procedure under direct or indirect supervision is made by the supervising physician based on reasonable medical judgment regarding the probability of morbidity and mortality to the patient. Furthermore, the supervising physician must be certain that the physician assistant is knowledgeable and skilled in performing the tasks and procedures assigned."

While this Florida Board of Medicine Final Order applies only to the specific fact scenario presented, it shows the type of important tasks and procedures a Florida licensed physician assistant who is properly trained and supervised may perform.

Note, however, that just because the physician assistant performs a task or procedure within the parameters of his or her license, does not mean the supervising physician is absolved from liability. Florida Statutes 458.347(3) states in part "Each physician or group of physicians supervising a licensed physician assistant …shall be individually or collectively responsible and liable for the performance and the acts and omissions of the physician assistant." Thus, the supervising physician or physician group remains responsible and liable for the physician assistant’s acts and omissions even when the physician assistant performs a task or procedure within the parameters of his or her license.