Medical Services Performable

The following are some examples of medical and surgical services performable by PAs. The flexibility of PAs being able to work in any setting or in any area of medical practice is demonstrated by the fact that PAs are working in every field of medicine and surgery. PAs are trained in general medicine, but are found in every specialty setting as well.

Among other services authorized, the PA Practice Act explains the delegated authority to issue drug orders, including those for Controlled Substances in Schedule II – V. The California Code of Regulations (CCR § 1399.541) below further provides a list, including – but not limited to, the types of services performed in PA practice.

1399.541 Medical Services Performable. This section describes the broad range of medical services that may be performed by a PA if delegated in writing by the collaborating physician. This sections states, in part:

“Because physician assistant practice is directed by a supervising physician, and a physician assistant acts as an agent for that physician, the orders given and the tasks performed by a physician assistant shall be considered the same as if they had been given and performed by the supervising physician. Unless otherwise specified in these regulations or in the delegation or protocols, these orders may be initiated without the prior patient’s specific order of the supervising physician.”

Subheadings (a) through (i) in this section lists the types of services that may be delegated to a PA. These include taking a history, performing a physical examination, ordering imaging or laboratory studies, counseling patients, arranging admissions and referrals and performing surgical procedures or acting as first assistant in surgery.

Subheading (h) describes the administration or ordering of medications and the criteria that must be met regarding written protocol and required countersignatures. It also states, in part:

“A physician assistant may not administer, provide or transmit a prescription for controlled substances in schedules II –V inclusive without patient-specific authority by a supervising physician.”

Note: Effective January 1, 2008, as a result of CAPA’s sponsored legislation, AB 3, California law establishes a mechanism for a PA to administer, provide, or issue a drug order for Schedule II through V controlled substances without patient specific advanced approval if the PA holds a certificate of completion from an education course that meets the requirements in Sections 1399.610 and 1399.612 of Title 16 of the California Code of Regulations. Click here to learn more.