PAs Supervising MAs: The Current Situation

by Michael Scarano, Jr., Esq.
CAPA Legal Counsel

CAPA frequently receives questions regarding PAs' ability to supervise medical assistants ("MAs"). Under Business and Professions Code Section 2069, PAs are permitted to supervise MAs when authorized to do so by the supervising physician.  However, pursuant to a provision in this statute which CAPA and many others view as outdated and impractical, a physician must be physically present at the practice site in order for an MA to provide services. There is an exception to this rule for licensed community clinics, where MAs may provide services under the supervision of a PA without a physician on site. The same rules apply to nurse practitioners, i.e., a nurse practitioner may only supervise MAs when a physician is on site, except in a community clinic.

CAPA sponsored a bill – SB 859 – which was heard on January 10, 2006 by the Assembly Business and Professions committee. It did not pass. It would have allowed PAs to supervise MAs in certain outpatient settings without a physician physically on the premises. Unfortunately, the California Nurses Association took a strongly opposed position. This is an election year. Nursing has enormous influence in the capitol. As with previous legislative efforts, AB 859 became the victim of "turf politics.” 

CAPA will persevere in changing this outdated law. While we are unaware of any enforcement action against PAs or physicians arising from the failure of a physician to be on site while an MA provided services for the PA, it is important for PAs to be aware of this law and to support CAPA's efforts to change it.