Legislation Update: Ionizing Radiation

February 1, 2012

Dear PAs of Massachusetts;
For years, Radiation Control (DPH) agreed that the Board of Registration in Medicine’s (BORIM) regulations allowing physicians to delegate “any medical service he or she wishes to a professional who is skilled to perform that service,” superseded DPH’s regulations prohibiting PAs from utilizing ionizing radiation. Approximately four years ago, DPH took the opposite stance halting all PAs from being able to perform ionizing radiation. For this reason, MAPA called on DPH to clarify the regulations of Radiation Control, Board of Registration Medicine (BORIM) and the PA Board of Registration. Recognizing that this limitation impacts clinical practice and patient care, MAPA has spent the last three years working with all the stakeholders to come to a resolution.

AAPA: Simultaneously, the AAPA and ASRT in collaboration, developed a training program and a test. The issue of PAs and ionizing radiation has been active across the country. This training and testing provides states an option for PAs to gain competency in performing ionizing radiation.

Radiation control (DPH)
has updated their regulations to include PAs as operators of fluoroscopy and defined training criteria. The regulation changes include many other aspects and the PAs were a portion of the changes. These regulation changes went to a public hearing, had a period of public comment and will now go back to the Public Health Council. The timing of finalization is still unclear.

Board of Registration in Medicine (BORIM)
regulation changes include language that would allow PAs to be operators of fluoroscopy and defines criteria for PAs and their supervising physicians. These changes have gone through all the necessary steps and should be finalized and posted in early February. MAPA played a key role in these regulation changes. The initial draft required direct and personal supervision of the PA by a physician. This requirement was removed based on comments submitted by PAs, physicians, MAPA, AAPA and others.

PA Board of Registration has drafted language that will be very similar to BORIM and will not change the overall intent. They have been submitted and are waiting for a public hearing date.

The following alert is from the PA Board of Registration:
Physician Assistants are subject to the regulations of the Board of Registration of Physician Assistants. The regulations at 263 CMR 5.04 (3) (b) prohibit physician assistants from “perform(ing) any procedure involving ionizing radiation except in an emergency where the procedure is performed under the direction and control of a licensed physician.” Until such time as the PA regulations are amended, physician assistants may not perform procedures involving ionizing radiation regardless of any amendments to the regulations of the Board of Registration in Medicine and/or the Radiation Control Program.

Please contact me if you have any questions.

Heather Trafton MS, PA-C, Legislative Chair, MAPA

Posted in Legislation.