 |
Texas Statutes (Last Updated: January 4, 2014) |
 |
OCCUPATIONS CODE |
|
Title 3. HEALTH PROFESSIONS |
|
Subtitle B. PHYSICIANS |
|
Chapter 157. AUTHORITY OF PHYSICIAN TO DELEGATE CERTAIN MEDICAL ACTS |
|
Subchapter B. DELEGATION TO ADVANCED PRACTICE NURSES AND PHYSICIAN ASSISTANTS |
Sec. 157.053. PRESCRIBING AT PHYSICIAN PRIMARY PRACTICE SITES
-
(a) In this section, "primary practice site" means:
(1) the practice location of a physician at which the physician spends the majority of the physician's time;
(2) a licensed hospital, a licensed long-term care facility, or a licensed adult care center where both the physician and the physician assistant or advanced practice nurse are authorized to practice;
(3) a clinic operated by or for the benefit of a public school district to provide care to the students of that district and the siblings of those students, if consent to treatment at that clinic is obtained in a manner that complies with Chapter 32, Family Code;
(4) the residence of an established patient;
(5) another location at which the physician is physically present with the physician assistant or advanced practice nurse; or
(6) a location where a physician assistant or advanced practice nurse who practices on-site with the physician more than 50 percent of the time and in accordance with board rules provides:
(A) health care services for established patients;
(B) without remuneration, voluntary charity health care services at a clinic run or sponsored by a nonprofit organization; or
(C) without remuneration, voluntary health care services during a declared emergency or disaster at a temporary facility operated or sponsored by a governmental entity or nonprofit organization and established to serve persons in this state.
(b) At a physician's primary practice site, a physician licensed by the board may delegate to a physician assistant or an advanced practice nurse acting under adequate physician supervision the act of administering, providing, or carrying out or signing a prescription drug order as authorized through a physician's order, a standing medical order, a standing delegation order, or another order or protocol as defined by the board.
(c) Physician supervision of the carrying out and signing of prescription drug orders must conform to what a reasonable, prudent physician would find consistent with sound medical judgment but may vary with the education and experience of the particular advanced practice nurse or physician assistant. A physician shall provide continuous supervision, but the constant physical presence of the physician is not required.
(d) An alternate physician may provide appropriate supervision on a temporary basis as defined and established by board rule.
(e) A physician's authority to delegate the carrying out or signing of a prescription drug order is limited to:
(1) four physician assistants or advanced practice nurses or their full-time equivalents practicing at the physician's primary practice site or at an alternate practice site under Section 157.0541 unless a waiver is granted under Section 157.0542(b-1); and
(2) the patients with whom the physician has established or will establish a physician-patient relationship.
(f) For purposes of Subsection (e)(2), the physician is not required to see the patient within a specific period.