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Collaborative Practice

Starting July 15, 2022, physician assistant practice in Oregon began shifting from a supervision model to a collaborative practice model as directed by the Oregon Legislature in HB 3036 (2021). Oregon licensed PAs may begin entering collaboration agreements.

We know there are many questions about the transition and how PAs will practice within a collaborative practice model, please review the list of Frequently Asked Questions.

Collaborative Practice Model

Collaborative practice is how a PA provides care and practices in Oregon by engaging in collaboration outlined in OAR 847-050-0080. ORS 677.495 defines “collaboration" as indicated by the patient's condition, community standards of care and a physician assistant's education, training and experience; and includes consultation between the PA and a physician or referral by the PA to a physician.

A PA must engage in collaboration with the appropriate health care provider as indicated by the condition of the patient, the community standards of care, and the PA's education, experience, and competence.
  • The degree of collaboration must be determined at the PA's primary location of practice. The determination may include decisions made by: a physician or employer with whom the PA has entered into a collaboration agreement, or the group or hospital service and the credentialing and privileging systems of the PA's primary location of practice.
  • The degree of autonomous judgment is determined at the PA's primary location of practice by the community standards of care and the PA's education, training, and experience.

Community standards of care is the degree of care, skill, and diligence that is used by ordinarily careful licensees in the same or similar circumstances in the licensee's community or a similar community.

Collaboration Agreements

A collaboration agreement is a written agreement that describes the manner in which the PA collaborates with physicians outlined in OAR 847-050-0082. The agreement does not assign supervisory responsibility to, or represent acceptance of legal responsibility by, a physician for the care provided by the PA. The agreement must be signed by the PA and a physician or PA's employer. A PA may not provide care unless the PA enters into a collaboration agreement, but a PA may practice under an existing practice agreement or description through 2023.

A sample collaboration agreement template is offered as a reference, but practices are encouraged to develop their own collaboration agreements.

A PA's collaboration agreement must be signed by a MD/DO/DPM physician or employer as defined in ORS 677.495.

A collaboration agreement must include:
  • The PA's name, license number, and primary location of practice;
  • The name of the physician or employer with whom the PA is entering the collaboration agreement;
  • A general description of the PA's process for collaboration with physicians and if applicable, include any differences in the process for collaboration based on practice location;
  • The performance assessment and review process; and
  • If the PA has fewer than 2,000 hours of post-graduate clinical experience, a Specified Collaboration Plan.
 
Specified Collaboration Plan: New PAs with less than 2,000 hours of post-graduate clinical experience (equivalent to one year of full time experience) must have a Specified Collaboration Plan in their collaboration agreement. The plan ensures the PA has access to consistent and quality collaboration with a specified physician on a regular basis during their first year of post-graduate clinical practice.
  • The PA must provide evidence of at least 2,000 hours of post-graduate clinical experience to the physician or employer with whom the PA is entering the collaboration agreement. The physician or employer entering the collaboration agreement is responsible for determining the PA does not require a plan.
  • “Post-graduate clinical experience" means the professional practice as a PA applying principles and methods to provide assessment, diagnosis, and treatment of patients.
  • The physician or employer has broad discretion to create a plan tailored to the new PA. There are no minimum requirements for supervision or chart review. The plan is meant to provide new PAs initial support through consistent and quality collaboration with a specified physician on a regular basis.
  • The PA and physician or employer decide who tracks the PA's 2,000 hours of post-graduate clinical experience to determine when the plan is no longer required.

The PA, physician, or employer do not need to notify the OMB upon entering a collaboration agreement. Collaboration agreements will not be filed with the OMB. Collaboration agreements must be kept on file at the PA's primary location of practice and made available to the Oregon Medical Board upon request.

Although collaboration agreements are available now, Oregon licensed PAs may continue practicing under an existing practice agreement or practice description during a transition period until December 31, 2023, when all Oregon licensed PAs must practice under a collaboration agreement.

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