(ii) The medical officer, the principal physician, the surgeon and the medical assistant shall conduct a medical record verification meeting at least once a month for at least 10 months of the year. According to SB 697`s sponsors, the legal restrictions were excessively onerous and twice as much as other protective measures built into the health system. SB 697 and section 3500 of the Trades and Professions Code that flows from it refer to the “growing shortage and poor geographical distribution of health services” and its objective of “promoting the effective use of the capacities of physicians and surgeons. allowing them to work with qualified PAs to provide quality care. The California Medical Association explained that “SB 697 allows any medical practice to have more autonomy in its functional relationship with its APs.” By eliminating perceived burdens and duplications, SB gives 697 physicians and surgeons more control over PAS monitoring methods. Therefore, instead of requiring an agreement between a particular AP and certain physician caregivers, the new law tightens PA agreements by allowing the use of the same practice contract for multiple PAs, not requiring the designation of certain physician caregivers, and not requiring the agreement to be signed by PA physicians. This should have the effect of significantly simplifying the practice of PA in health systems, where SAPs are often supervised by several physicians and where in the past they were required to enter into delegation agreements that designate each of these physicians. The shift from “physically available” to available by telephone or electronically, coupled with the removal of the file review requirement, creates additional risks. SAPs still need monitoring. Indeed, a strong argument can be made that the relaxation of forms of surveillance implies that other robust and specific processes, directives and procedures, as well as guidelines for PDOs, are posted in order to avoid a decline in the quality of surveillance. In addition, the removal of diagram verification and physical availability requirements does not mean that they cannot be included in the practice agreement. Together, these new provisions result in major changes that will allow health systems to have much more flexibility in determining SAP surveillance in their organizations. Instead of limiting PAs and physicians to one of the four modes of oversight provided for in existing legislation, each health system is free to create a single PA oversight structure, the most appropriate in the context of the organization (provided it meets the prudential requirements contained in the amended law).
This brings PA practice much closer to the practice of nurses (“NPs”) whose follow-up is determined by standardized procedures developed by each health system. Finally, SB 697 expands the prescribing power of APs by eliminating specific medical surveillance requirements and eliminating the requirement that the name and contact information of the attending physician appear on the prescriptions of an AP. See the bus. &Prof. Code § 3502.1, amended by SB 697 (valid from 1 January 2020). Instead, the practice agreement should define the supervision to be offered to the PA when prescribing medications, although a medical practitioner “must be reachable by telephone or other electronic communication method at the time the PA examines the patient.” Bus. &prof. Code § 3502.1 (c) (2). The new law removes these requirements. Instead, it says: “Supervision as defined in this subdivision should not be interpreted in such a way as to require the physical presence of the physician, but requires: (A) compliance with adequate supervision, as agreed in the practice contract. (B) the physician and surgeon who, at the time of examination of the patient by the PA, are reachable by telephone or other means of electronic communication. » Bus. & Prof.
Code § 3501 (f) (1), amended by SB 697 (valid from Jan. . . .
