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On Monday, August 29, 2011, the Louisiana State Board of Medical Examiners held a public hearing on a proposed rule change that would, if adopted as drafted, require a physician to be in specific proximity to a PA when the PA performed listed procedures. The Association of PAs in Cardiovascular Surgery joined the Louisiana Academy of Physician Assistants and AAPA state advocacy staff to provide testimony in opposition in a hearing room packed with PAs, PA students and physicians.
APACVS, LAPA and AAPA did a masterful job of informing physician-PA teams about the proposed rule, which was reflected in the overflowing room at the hearing. Representatives from all three organizations were joined in opposition by a host of physicians, including specialists in the areas of cardiology, cardiothoracic surgery, emergency medicine, and obstetrics and gynecology, all of whom provided testimony regarding the impact the proposed rule would have on patient care in the state. Representatives from large Louisiana hospital groups, including LSU Health Care Services and Oschner Health System, also testified in opposition. More than 50 PAs and physicians participated via “real time” webcast. AAPA state advocacy staff also provided testimony. No pro testimony was provided.
APACVS worked with the Society of Thoracic Surgeons to not only submit written testimony, but have prominent Baton Rouge cardiothoracic surgeon Dr. Eugene Berry deliver the message in person. In the letter, STS President Michael J. Mack, MD, stated, “[a]s a professional organization representing cardiothoracic surgeons in Louisiana practicing under the rules and regulations promulgated by your Board, [STS] respectfully request[s] that you rescind your proposal to restrict the practice of PAs in the state of Louisiana and rely on the best practices developed by our specialty, working with PAs to enhance quality care resulting in improved patient outcomes.”
As a result of the opposition to the rule, the LSBME quickly worked to amend the proposed rule, removing the language requiring certain levels of supervision for specific procedures. On May 17, 2012, the Louisiana Register published the final version of rules clarifying PA supervision. The new rule requires physicians to provide a level of supervision appropriate to the specific service provided by the PA, and for the PA to maintain a credentials file at the practice site.
This action closed the book on the LSBME’s multi-year effort to seek changes to rules governing physician supervision of PA practice. There is no doubt that the rule would have looked much different if not for the tireless advocacy efforts of APACVS, LAPA and AAPA.
August, 2012