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§47.31A Physician Assistant Negligence - Proof of Standard of Care

The Case:  Cox v. M.A. Primary and Urgent Care Clinic, 313 S.W.3d 240 (Tenn.2010).

The Basic Facts:  Plaintiff alleged that she was injured as a result of the negligence of a physician’s assistant.  She sought to use a doctor to testify as to the standard of care of the physician’s assistant.

The Bottom Line:


·      “We turn now to the central issue in this case: the standard of care applicable to physician assistants. Plaintiff argues in her brief to this Court that the Act establishes that a physician assistant is ‘actually practicing medicine on behalf of the supervising doctor’ and ‘as the doctor’s representative.’ Given that a physician assistant is practicing medicine, Plaintiff asserts, he or she must be held to the same standard of care applied to his or her supervising physician. This is an issue of first impression in Tennessee.” 313 S.W.3d at 255.


·       “Our close review of Tennessee’s statutes, which are similar to those of Delaware, convinces us that the General Assembly did not intend that physician assistants be held to the same standard of care as physicians when administering medical care. Rather, a fair reading of the Act, and the Rules promulgated thereunder, establishes that a Tennessee physician assistant is a medical provider who practices medicine within a specifically circumscribed scope of practice, under the close supervision of a medical doctor, and pursuant to a specific protocol developed with the supervising medical doctor. And, although we recognize that physician assistants exercise a degree of independent judgment in providing medical services, the Act makes clear that physician assistants do not have the same autonomy that is accorded to doctors. Physician assistants are statutorily limited to performing ‘only those tasks that are within the physician assistant’s range of skill and competence.’ Tenn. Code Ann. § 63-19-106(a)(3). Moreover, physician assistants are exposed to disciplinary action for practicing medicine without a license if they render professional services in a manner inconsistent with the Act. Id. § 63-19-108. It is logically inconsistent to impose significant limitations on physician assistants and yet simultaneously hold them to the same standard of care imposed upon their supervisors.”  Id. at 257 (footnote omitted).


·      “We hold that a physician assistant must be held to the ‘recognized standard of acceptable professional practice in the profession’ of physician assistants and any specialty thereof, and not to a standard applied to physicians. This is consistent with Tennessee’s longstanding recognition that, in a professional malpractice action, the defendant ‘is responsible for any damage which may result to those who employ him from the want of the necessary and proper knowledge, skill, and science which such profession demands.’ Wood v. Clapp, 36 Tenn. (4 Sneed) 65, 66 (1856) (emphasis added). Thus, ‘[p]rofessionals are judged according to the standard of care required by their [own] profession.  Dooley v. Everett, 805 S.W.2d 380, 384-85 (Tenn. Ct. App. 1990) (emphasis added); see also Restatement (Second) of Torts, § 299A (1965) (‘Unless he represents that he has a greater or less skill or knowledge, one who undertakes to render services in the practice of a profession or trade is required to exercise the skill and knowledge normally possessed by members of that profession or trade in good standing in similar communities.’). The profession of physician assistants is distinct from the profession of physicians. Therefore, in order to establish that a physician assistant has committed medical malpractice, the plaintiff must adduce testimony by an expert who is qualified to testify about (1) the standard of care applicable to physician assistants and (2) whether the physician assistant in question exercised ‘the reasonable degree of learning, skill, and experience that is ordinarily possessed by others of his profession.’Godbee v. Dimick, 213 S.W.3d 865, 896 (Tenn. Ct. App. 2006) (quoting Hopper v. Tabor, No. 03A01-9801-CV00049, 1998 WL 498211, at *3 (Tenn. Ct. App. Aug. 19, 1998)).” Id. at 258-59.

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The foregoing is an excerpt from Day on Torts: Leading Cases in Tennessee Tort Law, published by John A. Day, Civil Trial Specialist, Fellow in the American College of Trial Lawyers, recipient of Best Lawyers in America recognition, Martindale-Hubbell AV® Preeminent™ rated attorney, and Top 100 Tennessee Mid-South Super Lawyers designee. Read John’s full bio here.

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