NAC633.289. Supervising physicians: Responsibilities.

     1. A supervising physician is responsible for all of the activities related to the performance of medical services conducted by the physician assistant whom he or she supervises, including, without limitation:

     (a) Obtaining the medical histories of patients;

     (b) Performing physical examinations;

     (c) Ordering and performing diagnostic and therapeutic procedures;

     (d) Implementing a treatment plan outlined by a supervising physician;

     (e) Monitoring the effectiveness of therapeutic interventions;

     (f) Assisting at surgery;

     (g) Offering counseling and education to meet the needs of patients;

     (h) Making appropriate referrals; and

     (i) Pronouncing death, excluding the diagnosis of the cause of death.

     2. The supervising physician shall ensure that:

     (a) The physician assistant is clearly identified to the patients as a physician assistant;

     (b) The physician assistant performs only those medical services which are specified in the written collaborating agreement between the supervising physician and the physician assistant; and

     (c) The physician assistant strictly complies with:

          (1) The provisions of the registration certificate issued to the physician assistant by the State Board of Pharmacy pursuant to NRS 639.1373; and

          (2) The regulations of the State Board of Pharmacy regarding controlled substances, poisons, dangerous drugs or devices.

     3. A supervising physician:

     (a) Except as otherwise provided in NRS 633.469, shall provide supervision in person at least once each month to the physician assistant.

     (b) Must be available for consultation at all times during which the physician assistant is performing medical services.

     (c) Shall review and initial at least 10 percent of the charts of the patients of the physician assistant at least four times each year.

     (d) Shall develop and carry out a program to ensure the quality of care provided by the physician assistant, which must include, without limitation:

          (1) An assessment of the medical competency of the physician assistant;

          (2) A review and initialing of selected charts;

          (3) An assessment of a representative sample of the referrals or consultations made by the physician assistant with other health professionals as required by the condition of the patient;

          (4) Direct observation of the ability of the physician assistant to take medical histories from and perform examinations of patients representative of those cared for by the physician assistant; and

          (5) Maintenance by the supervising physician of accurate records and documentation regarding the program for each physician assistant supervised.

     4. A patient cared for by a physician assistant for a recurring illness that is not a chronic illness must be examined by the supervising physician of the physician assistant if the patient does not show improvement within a reasonable period of time.

     (Added to NAC by Bd. of Osteopathic Med. by R192-07, eff. 12-17-2008)