After completing a physician assistant degree program and obtaining your license, you will be allowed to write prescriptions for medications as one of your medical services. According to the American Academy of PAs, licensed PAs are permitted to issue prescriptions in all states and territories of the United States, except Puerto Rico.
Prescription power is provided by the state or territory in which a physician assistant practices, hence PAs in various states have varied restrictions on their prescribing ability. If you operate as a PA in any state, you may expect to collaborate with, or at least have your prescription practices evaluated by, your supervising physician, regardless of where you practice.
Restricted by Drug Class and Scheduling
Schedules of drugs, or classifications of narcotics as defined by the US Drug Enforcement Administration, are restricted in most states by law. An acceptable degree of usage and the risk for misuse and dependency are outlined in drug schedules. It is prohibited to possess or use any of the medications listed in Schedule I because they have no accepted medicinal purpose and a high potential for misuse. Prescriptions for Schedule I medicines cannot be written by a PA or any other doctor.
According to official policy, this prohibition extends to medicinal cannabis even though it has been legalized in most states for at least some medical uses since at least 2008. The American Medical Association Journal of Ethics notes that doctors write suggestions rather than formal prescriptions for medical marijuana in several states because of this.
There are certain states where physician assistants are also able to issue prescriptions for medicinal marijuana, depending on the sort of medical condition that is triggering the prescription.
An attending physician is required to submit this recommendation in California, for example, where PAs work. Only “disabling medical problems” are allowed for physician assistants to suggest medicinal marijuana in Colorado, not “debilitating and disabling disorders.”
Schedule II medicines, the second most hazardous class of pharmaceuticals, can be prescribed by PAs in certain states but not in others, according to the American Academy of PAs. Despite the fact that these medications have been approved for use in medicine, misuse and dependency are serious concerns.
States that allow physician assistants to prescribe Schedule II medicines may set extra conditions and restrictions on these prescriptions, including the number of days or hours during which they are authorized to administer this medication and whether refills may be issued. Drugs classified as Schedule II include oxycodone and fentanyl.
Only Schedule III and higher medicines can be prescribed by PAs in some states. As with acetaminophen with codeine and steroids, the misuse and dependency risk of these medications is low to moderate. Additionally, Schedule IV and V medications have a lower risk of misuse and dependency, as well as a lower risk of physical and mental dependence.
A PA’s ability to prescribe certain medications may be limited in some states by more than just the drug schedule. Depressants have always been barred by the American Academy of PAs from being prescribed by PAs in Iowa.
Writing Prescriptions Under the Supervision of a Physician
Only a licensed physician can supervise a physician assistant in the practice of medicine. According to the U.S. Bureau of Labor Statistics, one of the conditions for PA licensure is that the PA and the supervising physician sign a written agreement outlining the extent of the PA’s services and work responsibilities.
In addition to any statutory constraints on prescription authority for physician assistants, each PA is bound by the conditions of this agreement.
Your prescribing doctor may prefer to study the patient’s medical records first and write the prescription personally, or they may be OK with their physician assistants independently prescribing certain types of prescriptions. Doctors may also grant more prescription power to seasoned PAs than they do to young PA school graduates.
Finally, the doctor delegates activities associated with the practice of medicine to the PA when it comes to prescribing drugs and other issues.
