If a supervising physician is unavailable for an urgent but non-emergent issue, what should the PA do?

• A. Make independent decisions without supervision
• B. Activate backup supervision or standing protocols
• C. Contact the on-call supervisor, follow standing protocols, avoid unsafe care, and document actions
• D. Delay care until the supervising physician is available

Answer: (C)

When a supervising physician isn’t available for an urgent but non-emergent issue, the PA should not practice independently. The correct approach is to actively establish supervision and follow established guidelines: contact the on-call supervisor, activate backup supervision or standing protocols, follow those standing orders, avoid providing unsafe or unapproved care, and document every action taken. This keeps care within the agreed-upon framework, maintains patient safety, and provides a clear medical-legal record of what was done and why. Using standing protocols ensures the PA can address the patient promptly without waiting for the physician to be available, while still keeping the physician informed and in control. Delaying care or acting without supervision could jeopardize the patient and violate supervision requirements, and independent, unbriefed decisions are not appropriate in this context. Documentation of who was contacted, what protocols were followed, the rationale for decisions, and the patient’s status is essential for accountability.