Can Physician Assistant refract?

[LENNY]

Can they?

[Darris Chambless]

Hello Lenny,

No, not independantly. A PA can only do screenings and are required to refer the patient to the appropriate doctor as a result or get the approval and signature of an MD or DO on their assesment. It would seem logical that a PA (with more medical training than an OD, who can refract) should be able to legally refract one his/her own, but they cannot do anything without an MD or DO's (not OD) supervision and signature.

If an Ophthalmologist were willing to sign off on a PA refactive script they could, but then you could do the same yourself if you could find an MD or DO willing to do that for you.

Take care,

Darris C.

[NC-OD]

Physicians Assistants scope of practice varies by state but in many places, including here in NC, PA's have a great deal of autonomy.

I have a good friend who was a PA before going to OD school. (He CAN refract pretty good I guess).

I also have a branch optometry clinic set up in a medical clinic run by a P.A. He has complete control of all aspects of his patients care. There is a "phantom" MD (who I have never seen), who signs off on all of his records. State law require "consultation" with an MD (or DO) within 7 days of seeing the patients. Consultation could mean directly in person or "by phone". The physician does not ever have to actually see the patients. I found this very Interesting.

And VERY Hypocritical. The medical establishment has tried to fight down every other health professions expanding scope of practice from podiatrists, chiropractors and of course optometrists among other.

And now, fairly recently, they have allowed people with a 4yr college degree (which has recently been expanded to a masters degree in most places), to take over most of the duties normally performed by your average internist. And I have talked to some older MD's who are not too happy with this situation.

Of course the reason the PA were "allowed" to come about was , economics. It is amazing how capable and intelligent a person becomes to you when they benefit you financially.

Many OMD for years wouldn't bother even accociating with the lowly OD. But as soon as the referral center came about and the OD become a valuable source of revenue via surgical referrals, we all became drinking buddies .

And of course, you all know, the same holds true with opticans. As soon as you become a financial asset to someone.......you automatically gain about 50 I.Q. points. Am I right??:D ;)
If you work for the competition, you are an idiot. If you work for me your a genious!

But to answer the original question, yes P.A.'s could refract if they wanted. Fortunately, the ones I know are too busy doing the MD's job to mess with anything else.

P.S. This was not a rant against Physicians Assistants. I think most of them do a great job. It is a great example of the fact that the medical establishment does not have a patent on knowledge. Other people can learn too.

[chip anderson]

There is a provision in the law that states that a physician can deligate any duty to anyone, including surgery believe it or not. This is protect his being able tell someone how to give emergency and non-critical service. This is how us non-licensed states folks get to fit contact lenses on Rx even though we are independent. Now refraction is not usually rocket science and now even machines can do this. The law definitely applies to anyone in the physicician's employ, but the physician is totally responsible for anything such assistants do.

Chip

Don't worry about it, especially if it is in writting, you are not the state credential body. And your behind is covered.