SHERIDAN — A new law granting physician assistants additional practice and prescribing power went into effect Jan. 1, but PA practice at Sheridan Memorial Hospital won’t change much, according to hospital officials.
Signed by Gov. Mark Gordon in April 2021, the newly-effective law altered Title 33, the section of Wyoming statutes governing occupations and requiring certain levels of education, training and licensing for particular professions.
The law makes two primary changes. First, it removes the requirement that physician assistants be supervised by licensed physicians while practicing medicine. Second, it allows physician assistants to prescribe some medications without the approval of a licensed physician.
Physician assistants will now be able to prescribe Schedule II, Schedule III and Schedule IV medications, as defined by the federal government. According to the U.S. Drug Enforcement Administration’s scheduling guidelines, Schedule II drugs, such as ADHD medications Adderall and Ritalin as well as opioids oxycodone, fentanyl and hydrocodone, have a “high potential for abuse.” Schedule III drugs, including ketamine, anabolic steroids and testosterone, and Schedule IV drugs, including Xanax, Valium, Ativan and Ambien, have moderate to low likelihood of dependence.
During a Wyoming Legislative Senate Corporations, Elections and Political Subdivisions meeting Feb. 23, 2021, Sen. Fred Baldwin, R-Big Piney, also a PA, explained the bill was brought as part of a national movement recognizing PA contributions to medicine. The bill, Baldwin explained, maintains collaboration between PAs, doctors and other medical staff while acknowledging PAs qualifications to practice medicine.
During an emergency meeting of the Wyoming Board of Medicine earlier this month, Executive Director Kevin Bohnenblust asked the board to impose emergency rules for the implementation of the law and empower board staff to draft and propose longer-term rules for PA practice in the future.
“If [PAs are] certified from day one, they don’t have to be supervised,” Bohnenblust explained to the board, indicating the PA’s new practicing and prescriptive authority.
The board approved the emergency rules and plans to draft future PA regulations.
At Sheridan Memorial Hospital, however, PA practice won’t change much, according to Dr. Kristopher Schamber, a physician at SMH Internal Medicine.
Per SMH’s bylaws, all advanced practice clinicians, which includes PAs and nurse practitioners, at the hospital will continue to be supervised, Schamber said. This supervision can include physically evaluating more complex patients, reviewing care plans and documentation and discussing current patients.
Schamber said PAs prescribing authority will also remain unchanged at SMH. Prior to the new legislation, Schamber explained, PAs were allowed to prescribe Schedule II-IV medications without physician approval if delegated that authority by the supervising physician. The law never specified this delegation process, so many PAs were prescribing medication prior to the enactment of the new law.