Physician Assistants’ Petition Aims to Ease Prescription Access in Virginia

It isn’t unheard of in Virginia for patients to go days without access to certain prescribed medications if the order was written by a physician assistant.

However, a petition to remove a regulatory requirement that members of the medical industry say is primarily responsible for the delays is being considered by the Virginia Board of Medicine during its next meeting in August.

Submitted by the Virginia Academy of Physician Assistants this May, the petition aims to remove the requirement that a physician’s name must be listed on prescriptions for Schedule II through Schedule V drugs written by a physician assistant in the same patient care team.

Support for the removal also comes from numerous medical professionals, as seen in the nearly 200 public comments submitted on the petition.

Robert Glasgow, the Academy’s Chair of Government Affairs and a practicing physician assistant for over 30 years, said the requirement becomes an issue when pharmacists cannot find the physician’s name on a prescription order due to inefficiencies with electronic health record systems.

If this happens, Glasglow said, a patient has to wait to pick up their medication until the pharmacy can confirm the physician’s name – which could span a few hours or multiple days.

“If you have a kidney stone and you are in a good amount of pain, and you’re trying to get your pain medicine filled,” he said, “how long does someone want to sit around trying to pass a kidney stone without any management?”

The requirement is especially unnecessary, Glasgow said, considering that physician assistants have the license and authority to prescribe these controlled substances without a physician’s signature. Virginia law states physician assistants can only prescribe certain controlled substances listed in their individual practice agreements.

Physician assistants are “well-trained and highly educated, and it is certainly within our scope to write these prescriptions. No harm will come from not having the physician’s name on the prescription, and there’s no recognizable need to have it there,” Glasgow stated.

The current process requires physician assistants to submit a prescription with the physician’s name through an electronic health record system, which will then send the order to the patient’s pharmacy. However, Glasgow said there are “dozens” of these record systems medical professionals use in Virginia without a centralized database to catalog them, and not all have an option to include the physician’s name on the prescription.

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Many times, he said, physician assistants have to put the physician’s name in the system’s “notes” section, but this can be missed because not all pharmacists know to look for it.

“Then you start getting bounce backs when a patient shows up, and the script hasn’t been filled yet,” Glasgow said. “Then there’s a back and forth with the pharmacy and the prescribing clinician.”

Glasgow also emphasized there is no state law mandating this requirement – only a regulation he said was written “so many years ago” that now creates barriers to patient care and prevents physician assistants from practicing in the full scope of their license.

Diane Powers, Director of Communications for the Virginia Department of Health Professions, said the executive committee of the Board of Medicine will be discussing the petition and the comments received at its meeting on August 4.

The Department of Health Professions agency plan states, “The petitioners will be notified of the Board’s decision after that meeting.”

by Meghan McIntyre, Virginia Mercury

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