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Medicine
Date
Dec 6, 2023
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PROBLEM: PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSES Drs. Allison Jones and Emily Johnson
Pdf page: 175
A. Drs. Jones and Johnson's Plans for the Tesson Office:
1.
Licensing and Scope of Practice
: To comply with the laws regulating medical practice
in Allstate, Drs. Jones and Johnson should ensure that any physician assistant (PA) and
pediatric nurse practitioner (PNP) they hire for their Tesson office are appropriately
licensed and have scopes of practice that align with their qualifications. They should
verify that the PA and PNP are authorized to practice in the state and are capable of
providing the intended services, including trauma care.
2.
Supervision
: The doctors should establish clear guidelines for the supervision of the PA
and PNP in accordance with state regulations. Some states require direct supervision,
while others allow for a more collaborative practice agreement. Drs. Jones and Johnson
should work within the scope defined by state law.
3.
Affiliation with Ms. Mayo
: If Drs. Jones and Johnson wish to affiliate with Ms. Mayo,
they should ensure that this affiliation complies with state regulations. This may involve
setting up formal agreements that outline the roles, responsibilities, and supervision
requirements for Ms. Mayo and her practice.
4.
Patient Admissions
: Since Ms. Mayo currently has clinical privileges for childbirth
services at the community hospital, Drs. Jones and Johnson should ensure that patients
can be admitted by the internist in Tesson as required by the hospital's policies and state
regulations.
5.
High-Incidence Trauma Care
: When hiring a PA with trauma experience, they should
make sure the PA's scope of practice aligns with the type of care they plan to provide,
especially for farming and hunting injuries. They should also ensure the PA's licensing
and qualifications are in accordance with state law.
6.
Challenging Board Action
: If the Board takes action against them, Drs. Jones and
Johnson should seek legal counsel to assess the situation and determine the likelihood of
success in challenging the Board's action. The success of such challenges can vary
depending on the specific circumstances and the strength of their legal arguments.
B. Ms. Mayo's Practice and Ms. Ellis's Work:
1.
Ms. Mayo's Practice
: Ms. Mayo's practice may be permitted under Allstate statutes if
she operates within the scope of practice defined for certified nurse midwives. Drs. Jones
and Johnson should ensure that Ms. Mayo's practice aligns with state regulations. If they
acquire her practice, they should structure their relationship with her based on state laws,
including protocols for referrals and collaboration.
2.
Ms. Ellis's Work as a Physician Assistant
: Ms. Ellis's work as a physician assistant
should be permitted if she operates within the scope of practice defined for PAs in
Allstate. Drs. Jones and Johnson should ensure that Ms. Ellis is appropriately supervised
and that her actions are within the bounds of state law.
C. Allstate Statutes and ACA Goals:
Whether the Allstate statutes measure up to the goals of increasing access to lower-cost quality
care under the Affordable Care Act (ACA) can vary from state to state. It depends on how the
Allstate statutes are structured and enforced. To assess this, Drs. Jones and Johnson should
consult with legal experts who are well-versed in both state healthcare regulations and the ACA's
goals. They can evaluate whether the statutes in Allstate are facilitating or hindering the delivery
of cost-effective and quality care by ANPs and PAs, as envisioned by the ACA. They can also
explore opportunities to advocate for changes in state regulations if needed to better align with
these goals.
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