Please help up remove the language that an MD review clinical course and treatment for patients that present for acute complaint twice in a single episode of care.  This adds to burden for providers, especially physicians and no proven benefit to patients.  I work psychiatry and often need to try multiple medications before finding the one that works best.  How is contacting a physician who is often not on site and not familiar with my patient and interrupting the MD's patient care helpful? We all benefit from team approach in medical care and PAs are trained to ask for help and involve the MD when needed. Please trust us to do this and help prevent provider burnout by removing antiquated rules that just don't make any sense when thoughtfully considered. Thank you for your consideration.