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Take this quiz to see if there are areas of your state government affairs program that have room for improvement.

1. You need to talk to your supervising physician. You find her:

1. in the next exam room.
2. by phone as she is heading to the hospital for rounds.
3. under a mountain of charts that require her co-signature on your chart entries.

2. You are the chair of your state chapter's government affairs committee. Your committee consists of:

1. you.
2. you plus every member of board of directors because they "like to be involved."
3. you, plus 5 PAs who are not board members who represent a variety of practice settings and geographic locations in the state. Your vice-chair lives in the capital.

3. Your group adds a physician. This person will act as your supervising physician on occasion. In order for this to be legal, you will need to:

1. create a simple document that will be signed by both you and the physician and kept on file at the practice.
2. fill out a simple form and fax it to the medical board.
3. fill out a complicated form, write a check, and send them to the medical board.
4. fill out a complicated form, write a check, send them to the medical board, and wait until the next quarterly board meeting for approval.

4. The medical board is considering regulations that will put new requirements on those who use lasers.This is in the "early discussion" phase. You find out about this:

1. today. Your state society sends a PA to every medical board meeting as an observer, so you have immediate and first hand knowledge of board discussions.
2. in a month, when the board's minutes are posted on their Web site.
3. after rules that require on site supervision for PAs who use lasers are drafted.
4. after rules that require on site supervision for PAs are adopted.

5. The left handed outpatient Brain-o-Scope has just been approved for use by the FDA. You and your supervising physician are anxious to put this new technology to use in your outpatient neurology practice. Adding brainoscopy to your delegated scope of practice will require:

1. adequate training and evaluation of your proficiency by your supervising physician, and adding it to your list of delegated procedures kept on file at your practice.
2. training and evaluation as above, plus adding it to your delegated scope of practice document that is filed at the medical board.
3. training and evaluation as above, plus a medical board decision in favor of PAs being able to perform brainoscopy.
4. training and evaluation as above, plus a personal appearance at a medical board meeting and a board decision in favor of you being authorized to perform brainoscopy.

6. The receptionist says that Michelle Power is holding for you on line 1. You:

1. take the phone, knowing the Ms. Power is the chief lobbyist for the medical society, and say, "Hey, Michelle, thanks for the heads-up on that bill. We still on for lunch on Tuesday?"
2. take the phone, knowing that Ms. Power is the chief lobbyist for the medical society, and say, "Hello, Michelle, I've been meaning to call you. How are things going?"
3. take the phone, knowing that Ms. Power is the chief lobbyist for the medical society, and say, "Hello, Ms. Power, this is John Doe."
4. say, "Who?"

7. You are the first person on the scene of a multiple vehicle collision on a very remote highway. You tell your teenager to get on the cell phone and call 911 as you sprint toward the scene, knowing that:

1. your state law authorizes you to provide care in an emergency even in the absence of physician supervision, and your state's Good Samaritan coverage extends to PAs.
2. your state's Good Samaritan coverage applies to PAs, although whether or not you can legally provide the care you plan to provide in this situation is unclear.
3. although you will be doing what is medically and ethically required of you in this situation, you may be in violation of multiple laws.

8. You are very pleased to note that the keynote speaker at your upcoming state chapter CME conference will be:

1. the president of the medical society, speaking on a panel with the director of the state health department and the chair of the Senate Health committee on "The Health of North Dakota: The Next Ten Years."
2. the president of the medical society, speaking on "Caring for North Dakotans: The Team Approach."
3. you.

9. Over the past five legislative sessions, your state chapter has worked on which of the following:

1. bills to improve health coverage for all patients in your state, to mandate rear-facing infant car seats up to one year of age, to expand the state's Medicaid drug formulary, and to prevent elder abuse.
2. bills to improve health coverage, to mandate rear-facing infant car seats up to one year of age, to allow PAs to sign to receive sample medications, and to remove chart co-signature requirements for physician-PA teams.
3. bills to allow PAs to sign to receive sample medications and to remove chart co-signature requirements for physician-PA teams.
4. legislation to allow PAs to sign school sports physicals.

10. While working in the ED a nurse comes to tell you that a patient with known mental health problems is becoming increasingly agitated while waiting in an exam room. You:

1. go to see the patient right away, and en route ask the nurse to call the sheriff to come to the hospital to stand by in case the patient needs emergency involuntary admission.
2. go to see the patient right away, and en route ask the nurse to call your supervising physician and tell her to stand by in case you need a verbal order for an emergency involuntary admission.
3. go to see the patient right away, knowing that if an emergency involuntary admission is required you will be able to order it yourself.

Although the right answers are pretty obvious here, you may want to look at the answer key by clicking on the key symbol below . The answer key page provides a quick background on these issues, plus links to additional Academy resources.