PHYSICIAN ASSISTANT POLICY COMMITTEE MINUTES

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PHYSICIAN ASSISTANT POLICY COMMITTEE MINUTES

  1. 1. PHYSICIAN ASSISTANT POLICY COMMITTEE MINUTES November 13, 2003 The meeting was called to order at approximately 10:35 a.m. on Thursday, November 13, 2003. Committee members present: Lance Talmage, M.D.; Katherine Clark, D.O.; Robert Zaayer, P.A.- C; Michael Bowen, P.A.-C, Thomas Parish, PA-C and Mrs. Sloan. Staff members present: Diann Thompson, Barb Sibla, Thomas Dilling, Cathy Hacker, and Kay Rieve. Guests: Eric Blum, M.D. I. Review of September 11, 2003 Minutes. Dr. Talmage moved to approve the September 11, 2003 Physician Assistant Policy Committee minutes. Dr. Clark seconded the motion. All members voted aye. The motion carried. II. Review of supplemental utilization plans The committee started the meeting by discussing the supplemental utilization plan application from Akron Radiology’s supplemental utilization plan application that is requesting that their PA(s) be allowed to perform Hysterosalpingogram. The committee noted that this function is a procedure that requires complex observation, constant visual observation and analysis of the procedure and requires the medical judgement of a physician. Dr. Talmage moved to deny this application, due to the complexity of the procedure and the it is a diagnostic procedure that requires the medical judgement of a physician. Dr. Clark seconded the motion. All members voted aye. The motion carried. The committee then discussed the supplemental utilization plan application from Akron Radiology’s supplemental utilization plan application that is requesting that their PA(s) be allowed to perform Lumbar puncture.
  2. 2. November 13, 2003 PA Policy Committee Minutes Page 2 Dr. Blum stated that this procedure is done under fluoroscopic guidance on adults only and that all of his physician assistants are also licensed as radiology technicians. The committee requested that Dr. Blum put these assurances in writing and Dr. Blum stated that he would. Dr. Talmage moved to approve this request with the above clarification. Mr. Bowen seconded the motion. All members voted aye. The motion carried. The committee then discussed the supplemental utilization plan application from Akron Radiology’s supplemental utilization plan application that is requesting that their PA(s) be allowed to perform Hip Injections. Dr. Blum stated that this procedure is done under fluoroscopic guidance on adults only and that all of his physician assistants are also licensed as radiology technicians. The committee requested that Dr. Blum define the types of injections to be for the purpose of therapeutic contrast or steroid pain relief and that the number of observed procedures be amended to be 25 by the PA and 25 by the physicians. Dr. Talmage moved to table this request pending the above clarification. Mrs. Sloan seconded the motion. All members voted aye. The motion carried. The committee then discussed the supplemental utilization plan application from Akron Radiology’s supplemental utilization plan application that is requesting that their PA(s) be allowed to perform Paracentesis. Dr. Blum stated that this procedure is done under ultrasound guidance on adults only and that all of his physician assistants are also licensed as radiology technicians. The committee requested that Dr. Blum amend the number of observed procedures to be 25 by the PA and 25 by the physicians. Dr. Talmage moved to approve this request with the above clarification. Mr. Bowen seconded the motion. All members voted aye. The motion carried.
  3. 3. November 13, 2003 PA Policy Committee Minutes Page 3 The committee then discussed the supplemental utilization plan application from Akron Radiology’s supplemental utilization plan application that is requesting that their PA(s) be allowed to perform insertion of PICC lines Dr. Blum stated that this procedure is done under fluoroscopic guidance on adults only and that all of his physician assistants are also licensed as radiology technicians. The committee requested that Dr. Blum amend the number of observed procedures to be 25 by the PA and 25 by the physicians. Dr. Clark moved to approve this request with the above clarification. Dr. Talmage seconded the motion. All members voted aye. The motion carried. The committee then discussed the supplemental utilization plan application from Akron Radiology’s supplemental utilization plan application that is requesting that their PA(s) be allowed to perform thoracentesis. Dr. Blum stated that this procedure is done under ultrasound guidance on adults only and that all of his physician assistants are also licensed as radiology technicians. The committee requested that Dr. Blum amend this application to reflect 100% direct supervision, and that Dr. Blum have a letter submitted to the PA committee from the credentials committee or chief of staff of the hospital stating that PA’s would be credentialed by the hospital to perform this procedure. Dr. Talmage moved to approve this request with the above clarification. Dr. Clark seconded the motion. All members voted aye. The motion carried. The committee thanked Dr. Blum for attending and giving them valuable information. Dr. Blum thanked the committee for having him and left at this time. The committee then moved on to discuss the applications from Marietta Health Care Systems and HMT Dermatology that are being reconsidered for Shave Biopsy. The committee was given an expert opinion obtained by the board staff from Dr. Michael J. White, M.D. that stated that this procedure should be approved
  4. 4. November 13, 2003 PA Policy Committee Minutes Page 4 for PA’s to perform with the amendment that the physician would select all lesions prior to biopsy being performed. The committee requested that these applications be amended to reflect that the physician would see evaluate, identify the lesions and make the decisions for the biopsy prior to each procedure. The committee also stated that they would like a clarification of the type of biopsy (ie..scalpel or loop) and a brief description of how the procedure is performed. Mrs. Sloan moved to table these applications pending receipt of the above information. Mr. Parish seconded the motion. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Premier Cardiothoracic & Vascular Surgeons that are requesting that their PA’s be allowed to perform insertion of radial artery lines and insertion of central venous catheters. The committee noted that the training, education and supervision was in keeping with the applications that had previously been approved for these functions. Dr. Talmage moved to approve these applications. Mrs. Sloan seconded the motion. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Advanced Heart & Lung Surgeons that are requesting that their PA’s be allowed to perform insertion of radial artery lines and insertion of central venous catheters. The committee noted that the training, education and supervision was in keeping with the applications that had previously been approved for these functions. Dr. Talmage moved to approve these applications. Mr. Bowen seconded the motion. All members voted aye. The motion carried. The committee then moved on to discuss the application from Portage Valley Family Practice that is requesting that their PA’s be allowed to perform nerve conduction studies.
  5. 5. November 13, 2003 PA Policy Committee Minutes Page 5 The committee noted that the didactic & clinical training information was incomplete. They had questions regarding who would interpret the studies and what kind of records would be kept They also questioned the need for 100% offsite supervision. Ms. Hacker pointed out that there were several attempts to obtain information from this group. The committee recommended sending another letter to this group requesting clarification of the above information and inviting the physician to attend the next PAPC meeting to address the committees concerns. Mrs. Sloan moved to table this application pending receipt of the above information. Mr. Parish seconded the motion. All members voted aye. The motion carried. The committee then moved on to discuss the application from Portage Valley Family Practice that is requesting that their PA’s be allowed to writing orders for skilled/nursing home assisted living patients with MD countersignature within 72 hours, utilizing 100% offsite supervision. The committee requested that a letter be sent to this group to request that the physician attend the next PAPC meeting to address the committees question and concerns regarding this application. The committee also requested that the Dr. be notified that failure to respond within a reasonable amount of time would render these applications abandoned. Dr. Talmage moved to table this application pending the above information. Mr. Bowen seconded the motion. All members voted aye. The motion carried. The committee then moved on to discuss the application from Ohio Physical Medicine that is requesting that their PA’s be allowed to perform nerve conduction studies. The committee noted that this application did not include the didactic training portion of the application. They also requested that the group submit examples of the text and syllabus that would be used and an outline of the 10 hours of clinical training. Mrs. Sloan moved to table this application pending the above information. Mr. Bowen seconded the motion. All members voted aye. The motion carried.
  6. 6. November 13, 2003 PA Policy Committee Minutes Page 6 The committee then moved on to discuss the applications from University Surgical Group of Cincinnati that is requesting that their PA’s be allowed to perform: removal of temporary pacer wires, insertion of central venous catheters, insertion of chest tubes, insertion of arterial lines, removal of chest tubes, removal of swan ganz catheters, removal of intra aortic balloon pump, vein and artery harvesting, and endotrachael intubation with ACLS training. Mr. Bowen noted that he would need to abstain from this vote as he was part of this group. The remaining members noted that all of these procedures fell within the requirements for training, education and supervision that has previously been approved for these functions. Dr. Talmage moved to approve all of these applications. Mrs. Sloan seconded the motion. All members voted aye. Mr. Bowen abstained. The motion carried. The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: Laser hair removal. The committee noted that the level of training education and supervision was in keeping with the other applications for this function that had previously been approved. Dr. Talmage moved to approve this application. Mr. Bowen seconded. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: acne surgery. Mr. Parish advised the committee that this procedure was a very simple procedure and that it was performed by gently nicking the pimple and then applying gentle pressure with an instrument to extract the material from the pimple. Dr. Talmage moved to approve this application. Mr. Bowen seconded. All members voted aye. The motion carried.
  7. 7. November 13, 2003 PA Policy Committee Minutes Page 7 The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: cryotherapy. The committee noted that the procedure was within the ability of a PA and that the training, education and supervision were sufficient. Dr. Talmage moved to approve this application. Mr. Bowen seconded. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: intralesional injections. The committee requested that the physician send in an amendment that would assure the board that he would identify the lesion and make the decision for the treatment prior to the treatment being performed. Mr. Parish moved to approve this application with the above amendment. Mr. Bowen seconded. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: shave biopsy. The committee requested that the physician send in an amendment that would assure the board that he would identify the lesion and make the decision for the treatment prior to the treatment being performed. Dr. Talmage moved to approve this application with the above amendment. Mr. Bowen seconded. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: snip excision. The committee requested that the physician send in an amendment that would assure the board that he would identify the lesion and make the decision for the treatment prior to the treatment being performed. Dr. Talmage moved to approve this application with the above amendment. Mr. Bowen seconded. All members voted aye. The motion carried.
  8. 8. November 13, 2003 PA Policy Committee Minutes Page 8 The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: excisional punch biopsy. The committee requested that the physician send in an amendment that would assure the board that he would identify the lesion and make the decision for the treatment prior to the treatment being performed. Dr. Talmage moved to approve this application with the above amendment. Mr. Bowen seconded. All members voted aye. The motion carried. The committee then moved on to discuss the applications from Affiliated Dermatology that is requesting that their PA’s be allowed to perform: electrodessication The committee requested that the physician send in an amendment that would assure the board that he would identify the lesion and make the decision for the treatment prior to the treatment being performed. Dr. Talmage moved to approve this application with the above amendment. Mr. Bowen seconded. All members voted aye. The motion carried. III. Review changes to the supplemental PA utilization plan application The committee reviewed and discussed the changes that had been made to this application and agreed to continue to revise this application. IV. Correspondence The committee acknowledged the correspondence that was handed out was for informational purposes and no one had any comments to make. The PA Policy Committee meeting was adjourned at approximately 1:10 p.m. on Thursday, November 13, 2003. I hereby attest that these are true and accurate minutes of the Physician Assistant Policy Committee of the State Medical Board of Ohio, meeting on November 13, 2003. Robert Zaayer, P.A.-C
  9. 9. November 13, 2003 PA Policy Committee Minutes Page 9 Chair Copies of documents and/or materials referenced in the minutes of the Physician Assistant Policy Committee meeting are available at the Board offices.

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