4731-4-03  Supervision.

(A) A supervising physician shall supervise a physician assistant within the terms, conditions, and limitations set forth in a standard or supplemental physician assistant utilization plan approved by the board, including the degree of supervision specified in that plan.

(B) As used In any standard or supplemental physician assistant utilization plan, the terms direct supervision, on-site supervision, and off-site supervision mean the following:

(1) “Direct supervision” means that the supervising physician is actually in sight of the physician assistant when the physician assistant is performing the function requiring direct supervision.  Although the physician may be performing some other task at the same time, he is physically present in the same room, so that he may immediately provide direction or assume the performance of the task if difficulties arise.  This does not require that the physician is watching “over the shoulder” of the physician assistant as would be required during the training period to ensure that the physician assistant is competent to perform the task.  The term “immediate presence” means that direct supervision is being provided.  While direct supervision would not be required for performance of tasks included on a standard utilization plan, it may be required for certain functions carrying high risks that are requested on a supplemental utilization plan.

(2) “On-site supervision” requires the physical presence of the supervising physician in the same location (e.g., the physician’s office suite) as the physician assistant, but does not require his physical presence in the same room.  This level of supervision is normally required by statute for all physician assistants when new patients are being seen.  It is also required by statute for all physician assistants practicing within a facility’s emergency department.  This level of supervision may also be appropriately required for the performance of specific functions requested through a supplemental utilization plan.  If a physician states in the standard utilization plan that supervision will be on-site at all times, then he and the physician assistant must practice in accordance with that declaration.

(3) “Off-site supervision” means that the supervising physician must be continuously available for direct communication with the physician assistant and must be in a location that under normal conditions is not more than sixty minutes travel time from the physician assistant’s location.  Off-site supervision is appropriate for some functions included in the standard utilization plan (subject to the additional restraints of division (D) of section 4730.21 of the Revised Code), but would rarely be authorized for functions requested on supplemental utilization plans.

(C) When a supervising physician authorizes a physician assistant to practice in a facility’s emergency department, the supervising physician shall provide on-site supervision of the physician assistant, unless certain services requiring direct supervision are specified in a standard or supplemental physician assistant utilization plan and approved by the board.

(D) A patient new to a physician’s practice may be seen by a physician assistant only when a supervising physician is on the premises, except in those situations specified in a standard or supplemental utilization plan under which the presence of the physician is not necessary.  A patient new to a physician’s practice or an established patient of a physician with a new condition shall be seen and personally evaluated by a supervising physician prior to initiation of any treatment plan proposed by a physician assistant for the new patient or the established patient’s new condition.

Effective:    9/1/00