Testimony in Support of H1542/S1067
An Act Relative to Ionizing Radiation
Public Hearing of the Joint Committee on Public Health
April 12, 2011
Massachusetts Association of Physician Assistants
Heather Trafton, MS, PA-C, Legislative Chair
Thank you for the opportunity to appear before you today. My name is Heather Trafton, and I am here representing the Massachusetts Association of Physician Assistants (MAPA), the professional society for the more than 1,800 PAs who are registered to practice in Massachusetts.
We are especially grateful to Senate Majority Leader Fred Berry and Representative Jim Vallee for filing this legislation to address concerns around the performance of ionizing radiation by physician assistants.
I am here to testify in strong support of H1542/S1067, a bill that would allow physicians to delegate procedures using ionizing radiation, including fluoroscopy, to physician assistants (PAs) who have completed a required course in radiation safety.
As you know, PAs practice medicine with physician supervision in every specialty, clinical setting, and geographical area of Massachusetts. A PA’s scope of practice is determined by the supervising physician, and must be within the scope of the supervising physician’s practice and appropriate to the PA’s training and experience.
Many of the procedures that PAs are delegated in Massachusetts and around the country are most safely performed using fluoroscopic guidance. Fluoroscopy allows PAs to visualize sensitive anatomical structures in real time during a procedure. To name a few of the common procedures which typically require fluoroscopic guidance: relocation of a fractured bone, central line placement, and cardiac catheterization.
In fact physician assistants have been conducting diagnostic and interventional procedures involving ionizing radiation, including fluoroscopy since the outset of the profession. Recently however, confusion and discrepancies have arisen with a change in interpretation of the regulations set forth by the Board of Registration in Medicine (BORIM), and those of the Department of Public Health (DPH). For many years Radiation Control agreed that BORIM’s regulations which states clearly that physicians may delegate “any medical service he or she wishes to a professional who is skilled to perform that service,” superseded DPH’s regulations which prohibits PAs from utilizing ionizing radiation.
PAs are often used to extend access to care in rural and underserved communities. PAs in these settings need to use ionizing radiation to take a plain film in order to rule out a broken bone or diagnose pneumonia. If PAs are prohibited from using ionizing radiation, necessary treatment could be delayed while patients wait for a radiographer to arrive from a different location, or worse yet, they might have to schedule a new appointment at a different location altogether.
Of course, as health care providers, patient safety is our number one concern. We would not support a bill that allowed unqualified providers to use ionizing radiation. Currently – PAs receive the same radiation safety education the physicians receive pertaining to and relative to the positions they hold. The proposed legislation would set Radiation Safety standards for all PAs practicing in these areas by requiring adequate training and education.
Finally, it is important to understand that this is not a move towards independent practice. This legislation would simply modernize state statues to allow PAs to continue practices they have been performing safely throughout MA and throughout the country.
Again, thank you for allowing me to speak with you today about this important health care issue. I would be happy to answer any questions that the Committee might have.