4731-4-01  Standard functions.

(A) The physician assistant shall perform only in the manner and to the extent set forth in the standard utilization plan and any supplemental plans of the supervising physician as approved by the state medical board.  Further, the physician assistant shall perform only within the degree of supervision specified in the standard utilization plan and any supplemental plans of the supervising physician as approved by the state medical board. 

(B) Pursuant to a standard utilization plan as approved by the board, a supervising physician may authorize a physician assistant to perform the following functions:

(1) Under “off-site supervision, on-site supervision, or direct supervision” as defined by rule 4731-4-03 of the Administrative Code:

(a) Obtaining comprehensive patient histories;

(b) Performing physical examinations, including audiometry screening, routine visual screening, and pelvic, rectal, and genital-urinary examinations when indicated;

(c) Initiating, requesting and/or performing routine laboratory, radiologic and diagnostic studies as indicated;

(d) Identifying normal and abnormal findings on histories, physical examinations, and commonly performed initial laboratory studies;

(e) Assessing patients;

(f) Developing treatment plans for patients;

(g) Implementing treatment plans that have been reviewed and approved by the supervising physician, subject to the supervision requirements of rule 4731-4-03(D) of the Administrative Code;

(h) Monitoring the effectiveness of therapeutic interventions;

(i) Providing patient education;

(j) Instituting and changing orders on patient charts as directed by the supervising physician, with any such orders written by the physician assistant to be reviewed by a supervising physician within twenty-four (24) hours after the order is written and countersigned if the order is appropriate;

(k) Screening patients to aid the supervising physician in determining need for further medical    attention;

(l) Performing developmental screening examinations on children as relating to neurological, motor and mental functions;

(m) Performing care and suturing and removal of sutures of minor lacerations;

(n) Applying cast or splint and removing such cast or splint under direction of the supervising physician.  Such application shall be made only after examination by the supervising physician;

(o) Administering medication and intravenous fluids upon order of the supervising physician;

(p) Removing superficial foreign bodies after consultation with the supervising physician and under his direction;

(q) Inserting a Foley or Cudae catheter into the urinary bladder or removing the catheter;

(r) Performing cardio-pulmonary resuscitation;

(s) Carrying out or relaying the supervising physician’s orders for medication, to the extent permitted under laws pertaining to drugs;

(t) Noninvasive application of skeletal traction under physician order;

(u) Removing intrauterine devices;

(v) Performing punch biopsies of superficial lesions;

(w) Removing arterial lines;

(x) Removing central venous catheter;

(y) Inserting and removing nasogastric tube; and

(z) Adjusting skeletal traction, excluding cervical traction, as ordered by the supervising physician.

(2) Under “on-site or direct supervision” as defined by rule 4731-4-03 of the Administrative Code:

(a) Injection of contrast for IVP under direct supervision.

(3) Assisting in surgery in a hospital, as defined in section 3727.01 of the Revised Code, or an outpatient surgical care center affiliated with the hospital if the center meets the same credential, quality assurance and plan review standards as the hospital, provided that these physician-supervised procedures have been delineated within the scope of practice of a physician assistant and approved by the appropriate committee of the hospital or outpatient surgical care center where such services are to be rendered.

(a) A physician assistant shall function as a physician assistant assisting in surgery only when under the direct supervision of the surgeon who is present during the surgery and only when the participation of a physician assistant assisting in surgery is indicated on the informed consent form.  The performance of the following listed tasks is solely for the purpose of assisting the surgeon in performing a safe operation and shall not be construed to allow the physician assistant to perform surgery.  The tasks a physician assistant assisting in surgery may perform include, but are not limited to, the following:

(i) handling of tissue;

(ii) using instruments (e.g., retractors);

(iii) providing hemostasis; and

(iv) placing sutures as part of the surgical procedure;

(b) A physician assistant functioning as a physician assistant assisting in surgery may close subcutaneous tissue and skin when the surgeon who performed the surgery provides supervision in close proximity within the surgical suite.

(c) No physician assistant shall otherwise perform surgery, act as a surgeon, hold himself or herself out as a surgeon, practice medicine independently, or hold himself or herself out as a physician as defined in Chapter 4731. of the Revised Code. 

(d) No person registered as a physician assistant under Chapter 4730. of the Revised Code shall engage in the practice of assisting in surgery unless the physician assistant meets the requirements of Chapter 4730. of the Revised Code and this Chapter of the Administrative Code.

(e) No physician assistant shall perform a surgical task or procedure which is the primary purpose of the surgery.

Effective:    9/1/00