Physician assistants seek broader scope of practice in Indiana

Physician assistants have licensing authority to write prescriptions in forty-nine states plus the District of Columbia.

But in Indiana, turf battles between physicians and physician assistants have resulted in physician assistants lacking the requisite legislative authority.

PAs complain that this slows down patient care, and they have introduced legislation six times to try to change their authority.

What's interesting is that turf battles in complementary and alternative medicine often mirror those in conventional medicine. For example, the turf battle between medicine and chiropractic as to whether chiropractors can assess and treat patients beyond dealing with "subluxations," "spinal health," and "transmission of nerve energy" is mirrored in litigation between orthopedic surgeons and podiatrists as to whether the ankle is part of the foot (for purposes of legislative authority to treat).

"Under Indiana regulations, PAs must consult in person or via phone or e-mail with the supervising doctor within 24 hours of any patient encounter, so even in a recheck or what appears to be a minor injury, every case is reviewed with the doctor. Usually at ONE offices, patients first see the PA, who can do the history and physical, then are seen by the doctor, so consultations are done immediately."

But nurse practitioners have prescriptive authority.

Argue one source: "Not allowing prescriptive rights by PAs will worsen Indiana's lack of primary medical care, particularly in rural areas."

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Law Offices of Michael H. Cohen offers general corporate legal services, litigation consultation, and expertise in health law, with a unique focus on alternative, complementary, and integrative medical therapies.

Michael H. Cohen is also President of the the Institute for Integrative and Energy Medicine, also known as the Institute for Health, Ethics, Law, Policy & Society. The Institute serves as a reliable forum for investigation and recommendations regarding the legal, regulatory, ethical, and health policy issues involved in the judicious integration of complementary and alternative medical therapies (such as acupuncture and traditional oriental medicine, chiropractic, massage therapy, herbal medicine) and conventional clinical care.

The most recent book written by Michael H. Cohen on health care law, regulation, ethics and policy pertaining to complementary and alternative medicine and related fields is an interdisciplinary collection of essays entitled, Healing at the Borderland of Medicine and Religion. This is the fourth book in a series, begun with Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives (1998).