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Osteopathic Prescribing, Scope of Practice Expansion, and Title Protection
By: Mark DeSantis, PA-C, Governmental Affairs Chairman

In my last article I updated everyone on the proposed osteopathic prescriptive regulations. We had completed the first of several public comment periods that was very successful. Board counsels’ task is to read all comments submitted and report those comments to the Board. The December meeting of the osteopathic board was cancelled, so I can’t tell you what has been said. However, by reviewing the many blinded copies that the PSPA office received, I can tell you that there were a lot of positive comments made. The regulations and comments are being reviewed by the Internal Regulatory Review Commission as well. We continue on pace to hopefully see completion of this process by early next year.

Our scope of practice expansion bills (HB1999 & HB2051) were introduced in November. The primary sponsor is Timothy Seip of Pottsville, PA. Representative Seip and I testified in front of the House Professional Licensure Committee in support of the legislation. This legislation will clarify our ability to order physical and occupational therapy, make referrals to athletic trainers, and perform teacher certification physicals amongst other problems that have created barriers to our practice. At this point in time, there seem to be no objections regarding this legislation. We hope to have them passed through the house and senate by the end of summer session.

During that testimony, we also took the opportunity to discuss the issue of title protection. This issue arose through several of our members who have concerns regarding orthopedic technicians who are acting in the capacity of physician assistants in the Commonwealth. The orthopedic physician assistant, (“OPA”) profession formally existed in the 1970’s, jointly sponsored by the American Medical Association and the Orthopedic Association. The A.M.A withdrew its’ support early on in the program and it lost its’ certification and the formal program was disbanded. Graduates at the time were not trained as physician assistants and they did not sit for the NCCPA exam. There are diploma programs for orthopedic technicians in existence today. The graduates of these programs have a very narrow scope of practice. They can infringe however on some of the same technical procedures that we as PAs perform. Their training is nowhere near as comprehensive as ours and they cannot be reimbursed for their services. The AAPA has a position paper specifically addressing the differences. The AAPA has also had numerous and ongoing discussions with their national organization regarding the confusion. The PSPA has asked the Bureau of Professional & Occupational Affairs to look into the matters in Pennsylvania. Patients need to know the types of professionals that are treating them and their capabilities. If this is an issue that you are dealing with, you need to bring it to the attention of the medical staff office and legal counsel for the hospital. Review the hospital bylaws and see what duties and procedures the orthopedic technicians are credentialed to perform. Bring any discrepancies to the administrations’ attention.

This scenario is what leads us to discuss title protection. Section 18 of the Medical Practice Act, which deals with physician assistants, includes language for title protection already, but we want to strengthen it. The Osteopathic Act does not contain title protection language and we will be adding that language through House Bill 2051. The legislation will be addressed when the House and Senate reconvene in February. We will keep you updated on its’ progress.