The Federal Trade Commission weighed in on a dispute between two Iowa regulatory bodies regarding how physicians can supervise their physician assistants.
In a letter this week, FTC staff supported a proposal by the Iowa Board of Physician Assistants to maintain regulations that allow physicians to determine how they will supervise their assistants based on their individual practice and the physician assistants' experience.
At the same time, the FTC raised concerns over a conflicting rule implemented in August by the Iowa Board of Medicine that increased supervision of physician assistants.
The Iowa Board of Physician Assistants asked the FTC to weigh in on its proposed regulation after it failed to agree on a rule with the Iowa Board of Medicine. The two agencies were mandated by the state in 2015 to jointly adopt regulations. The Board of Physician Assistants previously adopted regulations of supervision on its own.
Plans to jointly adopt a rule fell through after the physician assistants board received negative public comments on the joint proposal in June 2016, according to the FTC letter. Although they failed to come to a joint agreement, the Iowa Board of Medicine went forward with the rule and adopted it in August 2016.
A request for comment from the Iowa Board of Physician Assistants was not immediately returned. Mark Bowden, executive director of the Iowa Board of Medicine, declined to comment on the FTC letter. Subcommittees from both agencies are set to meet Jan. 4 to discuss the rules, he said.
The rule imposed by the Iowa Board of Medicine requires a physician to meet in person with each of his or her physician assistants a minimum of twice a year. Under current Iowa statute, physicians are only required to have face-to-face meetings on a biweekly basis if their physician assistant works in a clinic where the physician is present less than 50% of the time. This can sometimes occur in rural areas where the physician assistant is miles away from the supervising physician.
The FTC questioned whether the additional requirement was necessary. Most Iowa physician assistants work in a physician's practice, so they interact regularly to discuss cases, the FTC said.
The agency also noted that 28 states don't require any face-to-face meetings between physicians and physician assistants. “The supervising physician and supervised PA should have flexibility to determine the most effective and efficient way to maintain an appropriate supervisory relationship,” the FTC said.
The rule by the Iowa Board of Medicine also requires supervising physicians to conduct an ongoing review of their physician assistant's patient charts. The FTC also questioned the necessity of this provision saying it could be “confusing and costly.” The agency again noted that 28 other states don't require such provisions.