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----- Advocacy Alert -----
Maryland state law and rules governing PAs, with the convening of a work group in 2018 by the Maryland Board of Physicians to review the PA law and assess areas for potential change coupled with the challenges presented by the COVID-19 pandemic create unique opportunities for continued improvement to the PA regulatory environment in the state.
What follows are proposed changes based upon the national and surrounding state statutes and consistent with the feedback from stakeholders.
The proposed changes are intended to update the PA statute section 15 to reflect current practice, allow better access to care and reduce the administrative burden on health care practices. This proposal does not recommend independent practice or incorporate AAPA’s Optimal Team Practice (OTP) policy. This includes, but is not limited to:
· Allowing scope of practice to be based upon a PA’s education, training, experience, and competencies
· Moving away from “supervision” to describe the nature of the PA working relationship with physicians and replacing it with “collaboration”
· Eliminating a delegation agreement to replace with collaboration registration. Reflecting the current practice with interdisciplinary healthcare teams.
· Eliminating the concept that a PA’s scope of practice should be based upon the physician’s scope. Allow PAs to practice within their education and training providing better access to treatment services.
· Eliminating the concept and distinction between “advanced” and “core” duties, consistent with the national standards and surrounding states.
· Eliminating the concept of agency or that the physician should be responsible for PA provided care, making PAs responsible for the care they provide consistent with all other disciplines in Maryland.
Comparison of States
Issue |
Delaware |
District of Columbia |
Maryland |
Virginia |
West Virginia |
Practice Agreement/ |
Yes |
Yes |
Yes |
Yes |
Yes |
Board Approves Agreement/Notification |
No |
No |
Yes |
No |
No |
PAs Practice in Collaboration |
Yes |
Yes* |
No |
Yes |
Yes |
Scope of Practice Determined at the Practice Site |
Yes |
Yes |
No |
Yes |
Yes |
Differentiation Made Between “Core” versus “Advanced” Duties |
No |
No |
Yes |
No |
No |
The District of Columbia uses “collaboration” when referring to PA practice in statute. Regulations have yet to be adopted to make this change.
Please join the Maryland Academy of PA's, and contribute to our newly invigorated Political Action Committee so that we can continue to advocate for our patients, and focus more time on them, and less time on paperwork.
Please feel free to reach out to me with any ideas, suggestions or questions at LegislativeDirector@mdapa.org.
Jennifer Grover, DHSc, MMS, PA-C, Legislative Director MdAPA