Scope of Practice

Can audiologists independently perform intraoperative monitoring (IOM) without supervision?

No, Georgia does not allow audiologists to perform IOM without supervision. Audiologists performing this function are typically supervised by a neurophysiologist (neurologist trained in IOM). In addition to the “active” monitoring of nerve function during surgery (the technical component) there is a “professional component” that involves interpreting the data. § 43-44-3

At the federal level, the Centers for Medicare and Medicaid Services (CMS) requires that audiologists/technicians be supervised by a neurologist and specifically prohibits the operating surgeon or anesthesiologist from providing that oversight.

When are pharmacists allowed to vaccinate patients in Georgia?

Pharmacists are allowed to administer all vaccinations with a valid prescription from a physician. Pharmacists are also able to enter into a Vaccine Protocol with a physician that allows them to administer the vaccination to a group of patients without prescriptions. § 43-34-26.1

What is the difference between collaboration and delegation between a physician and a pharmacist?

There are two types of relationships that can exist between physicians and pharmacists in Georgia. A collaborative agreementallows hospital pharmacists to work with medical staff members in managing drug therapies for patients in institutional settings. “Collaborate” means to work jointly with others as approved by an order from an institutional physician or pursuant to a protocol established in accordance with medical staff policy. Collaborative agreements can only exist in institutional settings such as hospitals and are broader than delegations. § 26-4-212: Safe Medications Practice Act.

Outside of an institutional setting, physicians can delegate authority to qualified pharmacists to modify drug therapy. These narrower agreements can take place between any physician and any qualified pharmacist. “Drug Therapy Modification” is defined as the adjustment of dosages, dosage schedules, and/or medications by a pharmacist under authority delegated and supervised by a physician. Such medications need not be pharmaceutically or therapeutically equivalent to the initial prescription issued to the patient by the prescribing physician. Here, a physician may delegate authority to a qualified pharmacist to modify drug therapy through a protocol for a patient under the physician’s direct medical care and supervision. § 43-34-24.

Can a physician delegate their schedule III/IV/I prescribing authority to a PA?

Yes, a physician assistant (PA) is permitted to prescribe schedule III, IV, or V drugs, dangerous drugs, or devices as if it is addressed in the PA’s job description that is filed with the Georgia Composite Medical Board. A PA is only permitted to perform the delegated duties in public or private places or facilities where the primary or alternate supervising physician regularly sees patients. Rules 360-5-.11 and 360-5-.12

PAs must clearly identify themselves as a PA to ensure that they are not mistaken by the public as a physician. They must wear a clearly legible name badge at all times with the words “Physician Assistant” on the badge. They should be addressed as Mr., Mrs., Ms./Miss. The PA or office staff must notify the patient that the patient has the right to see the physician prior to any prescription drug or device being prescribed by the PA. Rule 360-5-.11

When a patient receives medical services from a PA, the supervising physician’s involvement in the patient’s care, including their evaluation and follow-up care, shall be appropriate to the nature of the practice and the acuity of the patient’s medical issue, as determined by the supervising physician. § 43-34-109

Is a physician liable for the medical acts of their PA?

Yes, the law states that “the delegating physician shall remain responsible for the medical acts of the physician assistant performing such delegated acts and shall adequately supervise the physician assistant.” § 43-34-103.