I support the proposed regulatory change to language regarding physician/PA appropriate consultation rather than require review after the same complaint twice for the following reasons:
PAs provide professional, team-based medical care. When a consultation or referral is needed, it will be sought. As a team member, the PA will assess the patient and provide the best care, including consultation as needed. The second visit rule is too restrictive.
PAs have practice agreements. The practice level agreement is discussed with the PA/physician. Both providers have an understanding of the consultation process and when it is needed for that practice setting.
There are many patients that may require an expected second visit with the same complaint. I work in pediatrics. I do not often prescribe medication for the initial visit runny nose and cough and recommend follow up-for the ‘same acute complaint’ if there is not improvement. Then the patient returns with the same complaint in three weeks. Do I need to have this case reviewed by a physician when seeing this patient? Right now, by regulation, I do. Is this a waste of time and resources for the physician? Absolutely! Does this patient truly need to be seen by a physician? Not likely, but if I thought they did, I would for best patient care.