South Carolina Code 40-47-195. Supervising physicians; scope of practice guidelines
(B) Pursuant to this chapter, only licensed physicians may supervise another practitioner who performs delegated medical acts in accordance with the practitioner’s applicable scope of professional practice authorized by state law. It is the supervising physician‘s responsibility to ensure that delegated medical acts to other practitioners are performed under approved written scope of practice guidelines or approved written protocol in accordance with the applicable scope of professional practice authorized by state law. A copy of approved written scope of practice guidelines or approved written protocol, dated and signed by the supervising physician and the practitioner, must be provided to the board by the supervising physician within seventy-two hours of request by a representative of the department or board.
Terms Used In South Carolina Code 40-47-195
- Approved written scope of practice guidelines: means specific statements developed by a physician or the medical staff and a physician assistant that establish physician delegation for medical aspects of care, including the prescription of medications. See South Carolina Code 40-47-20
- Board: means the State Board of Medical Examiners for South Carolina. See South Carolina Code 40-47-20
- Delegated medical acts: means additional acts delegated by a physician or dentist to a physician assistant, respiratory care practitioner, anesthesiologist's assistant, or other practitioner authorized by law under approved written scope of practice guidelines or approved written protocols as provided by law in accordance with the applicable scope of professional practice. See South Carolina Code 40-47-20
- Department: means the Department of Labor, Licensing and Regulation;
(5) "Director" means the Director of the Department of Labor, Licensing and Regulation or the director's official designee;
(6) "Licensee" means a person granted an authorization to practice pursuant to this article and refers to a person holding a license, permit, certification, or registration granted pursuant to this article;
(7) "Licensing act" means the individual statute or regulations, or both, of each regulated profession or occupation which include, but are not limited to, board governance, the qualifications and requirements for authorization to practice, prohibitions, and disciplinary procedures;
(8) "Person" means an individual, partnership, or corporation;
(9) "Profession" or "occupation" means a profession or occupation regulated or administered, or both, by the department pursuant to this article. See South Carolina Code 40-1-20 - License: means a current document authorizing a person to practice. See South Carolina Code 40-47-20
- Medical staff: means licensed physicians who are approved and credentialed to provide health care to patients in a hospital system or a facility that provides health care. See South Carolina Code 40-47-20
- Physician: means a doctor of medicine or doctor of osteopathic medicine licensed by the South Carolina Board of Medical Examiners. See South Carolina Code 40-47-20
- Practice agreement: means a written agreement developed by an NP, CNM, or CNS and a physician or medical staff who agrees to work with and to support the NP, CNM, or CNS. See South Carolina Code 40-47-20
- Practitioner: means a person who has been issued an authorization to practice in this State. See South Carolina Code 40-47-20
(C) In evaluating a written guideline or protocol, the board and supervising physician or medical staff shall consider the:
(1) training and experience of the supervising physician;
(2) nature and complexity of the delegated medical acts being performed;
(3) geographic proximity of the supervising physician to the supervised practitioner; when the supervising physician is not located at the same site as the supervised practitioner, special consideration must be given to the manner in which the physician intends to monitor the practitioner, and prior board approval must be received for this practice unless otherwise provided in this chapter; and
(4) number of other practitioners the physician or medical staff supervises. Reference must be given to the number of supervised practitioners, as prescribed by law. When the supervising physician assumes responsibility for more than the number of practitioners prescribed by law, special consideration must be given to the manner in which the physician intends to monitor, and prior board approval must be received for this practice.
(D)(1) A physician or medical staff who are engaged in practice with a PA, NP, CNM, or CNS must:
(a)(i) hold permanent, active, and unrestricted authorization to practice medicine in this State and be actively practicing medicine within the geographic boundaries of this State; or
(ii) hold an active, unrestricted academic license to practice medicine in this State and be actively practicing medicine within the geographic boundaries of this State;
(b) have in place prior to beginning practice and during its continuation a practice agreement as defined in § 40-47-20(35) or scope of practice guidelines as defined in § 40-47-20(5), a copy of which the physician must make available to the board within seventy-two hours of a request;
(c) not enter into scope of practice guidelines or practice agreements with more than the equivalent of six full-time PAs, NPs, CNMs, or CNSs and must not practice in a situation in which the number of NPs, CNMs, or CNSs providing clinical services with whom the physician is working, combined with the number of PAs providing clinical services whom the physician is supervising, is greater than six individuals at any one time, provided, however, that the board may approve an exception to these requirements upon application by the physician, if the board determines that an exception is warranted and that quality of care and patient safety will be maintained;
(d) not enter into a practice agreement with a PA, NP, CNM, or CNS performing a medical act, task, or function that is outside the usual practice of that physician or outside of the physician’s training or experience, provided, however, that the board may approve an exception to this requirement upon application by the physician, if the board determines that an exception is warranted and that quality of care and patient safety will be maintained; and
(e) maintain responsibility in the practice agreement for the health care delivery team pursuant to rules and regulations of the Board of Medical Examiners.
(2) The board is authorized to conduct random audits of scope of practice guidelines and practice agreements.