Scopes of practice for physician associates
The professional services a physician associate (PA) can perform in New Zealand are defined by the scope of practice for which they are registered.
There are two key scopes of practice for PAs:
- Physician Associate Provisional General Scope of Practice (for the initial period of registration).
- Physician Associate General Scope of Practice (for PAs who have completed the provisional period).
Physician associate provisional scope of practice
A physician associate registered in the Physician Associate Provisional scope of practice may:
- Offer health assessments, take detailed patient histories, perform physical examinations, and order relevant diagnostic tests.
- Under supervision, contribute to diagnosis and the development and implementation of appropriate treatment and management plans.
- Offer health promotion and disease prevention advice.
- Undertake relevant non-patient contact activities.
Permitted minor surgical procedures
In low-risk clinical situations, a physician associate registered in the Physician Associate Provisional scope of practice may perform any minor surgical procedures, including suturing, excision of skin lesions and sebaceous cysts, punch biopsies and any other procedure or class of procedures, that fall within the clinical responsibilities defined through the employer credentialling, and that the physician associate’s current primary supervisor has approved the physician associate to perform.
Core requirements
A physician associate registered in the Physician Associate Provisional scope of practice must:
- Work in a Council-approved position under Council-approved supervision with a Council-approved supervision plan.
- Be credentialled by their employer to define their specific clinical responsibilities within the Physician Associate Provisional scope of practice and within each service environment in which they work, taking into account their qualifications, training and experience, and the resources and support available in that service.
- Practise only in a setting where onsite supervision is available.
A physician associate registered in the Physician Associate Provisional scope of practice must:
- Work in collaboration with patients, their whānau, communities, and the multi-disciplinary healthcare team to deliver equitable person/whānau-centred healthcare.
- Practise in a culturally safe way – promoting equity, inclusion and diversity of all population groups to support the provision of quality services that are culturally safe, equitable and responsive.
- Recognise when to seek the assistance and input of a vocationally-registered doctor
A physician associate registered in the Physician Associate Provisional scope of practice must ensure that their practice is:
- Consistent with their qualifications, training, and experience, individual competence, Council standards, and legislative requirements.
- Within the terms of the supervision requirements set by Council, their supervision agreement with their supervising doctor, and their employer-credentialled defined clinical responsibilities in each specific service environment.
Time limitation
Registration in the Physician Associate Provisional scope of practice is time-limited to a maximum of 36 months from the date of registration in that scope of practice.
If the registrant has not completed the requirements of the provisional scope of practice and successfully obtained registration in the Physician Associate General scope of practice within this time, their registration in the Physician Associate Provisional scope of practice will expire.
Physician associate general scope of practice
A physician associate registered in the physician associate general scope of practice may:
- Offer health assessments, take detailed patient histories, perform physical examinations, and order relevant diagnostic tests.
- Under supervision, contribute to diagnosis and the development and implementation of appropriate treatment and management plans.
- Offer health promotion and disease prevention advice.
- Undertake relevant non-patient contact activities
- Use their expertise in areas and roles such as leadership, management, education, policy and research.
Permitted minor surgical procedures
In low-risk clinical situations, a physician associate registered in the Physician Associate General scope of practice may perform any minor surgical procedures, including suturing, excision of skin lesions and sebaceous cysts, punch biopsies and any other procedure or class of procedures, that fall within the clinical responsibilities defined through the employer credentialling, and that the physician associate’s current primary supervisor has approved the physician associate to perform.
Core requirements
- A physician associate registered in the Physician Associate General scope of practice must:
- Work under employer-approved supervision of a doctor registered in a vocational scope of practice that is relevant to the practice setting and the physician associate’s role.
- Be credentialled by their employer to identify the specific clinical responsibilities they may perform within the Physician Associate General scope of practice and within each service environment in which they work, taking into account their qualifications, training and experience, and the resources and support available in that service.
- Practise only in a setting where onsite supervision is available.
A physician associate registered in the Physician Associate General scope of practice must:
- Work in collaboration with patients, their whānau, communities, and the multi-disciplinary healthcare team to deliver equitable person/whānau-centred healthcare.
- Practise in a culturally safe way – promoting equity, inclusion and diversity of all population groups to support the provision of quality services that are culturally safe, equitable and responsive.
- Recognise when to seek the assistance and input of a vocationally registered doctor.
A physician associate registered in the Physician Associate General scope of practice must ensure that all health care they provide is:
- Consistent with their education, individual competence, Council standards, and legislative requirements.
- Within the terms of the supervision requirements set by Council, their supervision agreement with their employer and supervising doctor, and their employer-credentialled clinical responsibilities.