Court of Appeals Sides with TMA On Unwritten Rule Issue

September 25, 2019

The Tennessee Court of Appeals recently sided unanimously with TMA in the matter of Norma J. Sparks, PA v. Tennessee Department of Health, Board of Medical Examiners Committee on Physician Assistants. TMA submitted an amicus curia brief in the case and the court issued its decision on Sept. 6.

The case involved a licensed physician assistant who fell under fire with her licensing board, the Tennessee Committee on Physician Assistants, in February 2017. Sparks, who worked part time in a free clinic in Grundy County after retiring from an unblemished 40 years in practice, was disciplined for prescribing controlled drugs while being supervised by a physician with no DEA certificate. Sparks carried a valid DEA certificate and infrequently wrote controlled drug prescriptions at the clinic. There is no rule that a supervising physician have a DEA certificate. TMA’s concern was that a PA, physician, or any health licensee for that matter, could be disciplined by his/her licensing board based on unwritten or unclear grounds.

TMA has long promoted physician-led, team-based healthcare delivery models as the safest and most effective care in Tennessee. The Sparks case has broad implications for doctors who collaborate with PAs and/or other midlevel providers. Physicians expect and deserve clear guidance in terms of prescribing and collaboration requirements, and relative liabilities, and should not be penalized for violating what TMA termed in its brief, the Court expressed in its opinion, “unwritten rules.”

In its brief, TMA urged the Court to force health professional licensing boards to clearly provide notice of the standards of practice to their licensees before taking disciplinary action against them. The State has until early November to appeal.