645—327.1 (148C) Duties.
	   327.1(1) The medical services to be provided by the physician assistant are those delegated by a supervising physician. The ultimate role of the physician assistant cannot be rigidly defined because of the variations in practice requirements due to geographic, economic, and sociologic factors. The high degree of responsibility a physician assistant may assume requires that, at the conclusion of the formal education, the physician assistant possess the knowledge, skills and abilities necessary to provide those services appropriate to the practice setting. The physician assistant’s services may be utilized in any clinical settings including, but not limited to, the office, the ambulatory clinic, the hospital, the patient’s home, extended care facilities and nursing homes. Diagnostic and therapeutic medical tasks for which the supervising physician has sufficient training or experience may be delegated to the physician assistant after a supervising physician determines the physician assistant’s proficiency and competence. The medical services to be provided by the physician assistant include, but are not limited to, the following:
	      a.    	 The initial approach to a patient of any age group in any setting to elicit a medical history and perform a physical examination.
	      b.    	 Assessment, diagnosis and treatment of medical or surgical problems and recording the findings.
	      c.    	 Order, interpret, or perform laboratory tests, X-rays or other medical procedures or studies.
	      d.    	 Performance of therapeutic procedures such as injections, immunizations, suturing and care of wounds, removal of foreign bodies, ear and eye irrigation and other clinical procedures.
	      e.    	 Performance of office surgical procedures including, but not limited to, skin biopsy, mole or wart removal, toenail removal, removal of a foreign body, arthrocentesis, incision and drainage of abscesses.
	      f.    	 Assisting in surgery.
	      g.    	 Prenatal and postnatal care and assisting a physician in obstetrical care.
	      h.    	 Care of orthopedic problems.
	      i.    	 Performing and screening the results of special medical examinations including, but not limited to, electrocardiogram or Holter monitoring, radiography, audiometric and vision screening, tonometry, and pulmonary function screening tests.
	      j.    	 Instruction and counseling of patients regarding physical and mental health on matters such as diets, disease, therapy, and normal growth and development.
	      k.    	 Function in the hospital setting by performing medical histories and physical examinations, making patient rounds, recording patient progress notes and other appropriate medical records, assisting in surgery, performing or assisting with medical procedures, providing emergency medical services and issuing, transmitting and executing patient care orders as delegated by the supervising physician.
	      l.    	 Providing services to patients requiring continuing care (i.e., home, nursing home, extended care facilities).
	      m.    	 Referring patients to specialty or subspecialty physicians, medical facilities or social agencies as indicated by the patients’ problems.
	      n.    	 Immediate evaluation, treatment and institution of procedures essential to providing an appropriate response to emergency medical problems.
	      o.    	 Order drugs and supplies in the office, and assist in keeping records and in the upkeep of equipment.
	      p.    	 Admit patients to a hospital or health care facility.
	      q.    	 Order diets, physical therapy, inhalation therapy, or other rehabilitative services as indicated by the patient’s problems.
	      r.    	 Administer any drug (a single dose).
	      s.    	 Prescribe drugs and medical devices under the following conditions:
	       (1)  	 The physician assistant shall have passed the national certifying examination conducted by the National Commission on the Certification of Physician Assistants or its successor examination approved by the board. Physician assistants with a temporary license may order drugs and medical devices only with the prior approval and direction of a supervising physician. Prior approval may include discussion of the specific medical problems with a supervising physician prior to the patient’s being seen by the physician assistant.
	       (2)  	 The physician assistant may not prescribe Schedule II controlled substances which are listed as depressants in Iowa Code chapter 124. The physician assistant may order Schedule II controlled substances which are listed as depressants in Iowa Code chapter 124 only with the prior approval and direction of a physician. Prior approval may include discussion of the specific medical problems with a supervising physician prior to the patient’s being seen by the physician assistant.
	       (3)  	 The physician assistant shall inform the board of any limitation on the prescriptive authority of the physician assistant in addition to the limitations set out in 327.1(1)“s”(2).
	       (4)  	 A physician assistant shall not prescribe substances that the supervising physician does not have the authority to prescribe except as allowed in 327.1(1)“n.”
	       (5)  	 The physician assistant may prescribe, supply and administer drugs and medical devices in all settings including, but not limited to, hospitals, health care facilities, health care institutions, clinics, offices, health maintenance organizations, and outpatient and emergency care settings except as limited by 327.1(1)“s”(2).
	       (6)  	 A physician assistant who is an authorized prescriber may request, receive, and supply sample drugs and medical devices except as limited by 327.1(1)“s”(2).
	       (7)  	 The board of physician assistants shall be the only board to regulate the practice of physician assistants relating to prescribing and supplying prescription drugs, controlled substances and medical devices.
	      t.    	 Supply properly packaged and labeled prescription drugs, controlled substances or medical devices when pharmacist services are not reasonably available or when it is in the best interests of the patient as delegated by a supervising physician.
	       (1)  	 When the physician assistant is the prescriber of the medications under 327.1(1)“s,” these medications shall be supplied for the purpose of accommodating the patient and shall not be sold for more than the cost of the drug and reasonable overhead costs as they relate to supplying prescription drugs to the patient and not at a profit to the physician or physician assistant.
	       (2)  	 When a physician assistant supplies medication on the direct order of a physician, subparagraph (1) does not apply.
	       (3)  	 A nurse or staff assistant may assist the physician assistant in supplying medications when prescriptive drug supplying authority is delegated by a supervising physician to the physician assistant under 327.1(1)“s.”
	      u.    	 When a physician assistant supplies medications as delegated by a supervising physician in a remote site, the physician assistant shall secure the regular advice and consultation of a pharmacist regarding the distribution, storage and appropriate use of presciption drugs, controlled substances, and medical devices.
	      v.    	 May, at the request of the peace officer, withdraw a specimen of blood from a patient for the purpose of determining the alcohol concentration or the presence of drugs.
	      w.    	 Direct medical personnel, health professionals and others involved in caring for patients in the execution of patient care.
	      x.    	 May authenticate medical forms by signing the form and including a supervising physician’s name.
	      y.    	 Perform other duties appropriate to a physician’s practice.
	      z.    	 Health care providers shall consider the instructions of the physician assistant to be instructions of a supervising physician if the instructions concern duties delegated to the physician assistant by the supervising physician.
	   327.1(2) Emergency medicine duties.
	      a.    	 A physician assistant may be a member of the staff of an ambulance or rescue squad pursuant to Iowa Code chapter 147A.
	      b.    	 A physician assistant shall document skills, training and education equivalent to that required of a certified advanced emergency medical technician or a paramedic.
	      c.    	 A physician assistant must apply for approval of advanced care training equivalency on forms supplied by the board of physician assistants.
	      d.    	 Exceptions to this subrule include:
	       (1)  	 A physician assistant who accompanies and is responsible for a transfer patient;
	       (2)  	 A physician assistant who serves on a basic ambulance or rescue squad service; and
	       (3)  	 A physician assistant who renders aid within the physician assistant’s skills during an emergency.