Testimony: HB 500 and 501
On May 3, 2007, Mark A. Piasio, MD, MBA, President of the Pennsylvania Medical Society, presented the following testimony to the Pennsylvania House of Representatives' Professional Licensure Committee.
Good morning. I’m Mark A. Piasio, MD, MBA, president of the Pennsylvania Medical Society and a practicing orthopedic surgeon from Dubois.
Let me begin by thanking Chairman Sturla and the members of this committee for allowing the Pennsylvania Medical Society to testify on House Bills 500 and 501, both of which are related to perfusionists and the role that they play in health care.
Perfusionists, also known as clinical perfusion scientists or extracorporeal technologists, play an important role in surgery suites across the Commonwealth. They are the professionals who run heart-lung machines during open-heart surgeries. In a nutshell, perfusionists keep blood and oxygen flowing through your body when the human heart is temporarily not functioning. Working closely with heart surgeons, they play a vital role in a very complicated procedure.
Unlike the physicians and nurses working beside them during an open heart surgery, Pennsylvania perfusionists are not required to be licensed by the state.
HB 500 and HB 501 respectively would require perfusionists to attain licensure with oversight by the State Board of Medicine and the State Board of Osteopathic Medicine.
Upfront, I want this committee to know that the Pennsylvania Medical Society does not oppose licensure for those who play such an important role in the operating room, if some specific and important changes are made to the legislation. In addition to national certification that only about 70 percent of perfusionists have, it’s fair to patients that these professionals are part of state oversight through licensure when they are qualified.
In fact, during the last legislative session when similar bills were introduced, we suggested, informally, three amendments to those bills to build upon patient safety initiatives. These suggestions we believe are important for patient care and should be included in HB 500 and 501.
First, under the medical boards, regulations for appropriate continuing medical education should be promulgated. CME is an accepted means to ensure that health care services are delivered at the highest level.
Second, licensing fees should be used by the state boards to offset expenses of their work. As such, perfusionist licensure fee should similarly go to the appropriate medical board.
Third, it is essential that both the state board of medicine and the state board of osteopathic medicine know what the other is doing, particularly when dealing with problematic situations such as when a perfusionist license might be suspended, restricted or denied. Coordination between the two boards will be important.
Within the new bills, HB 500 and 501, there is one section that we also would suggest altering the language. Specifically, we believe Section 3 (d) should read, “A perfusionist may perform perfusion to an individual being treated by a licensed physician under medical supervision and approval consistent with standing orders or protocols of a hospital AND APPROVED BY THE PHYSICIAN DESIGNATED AS THE MEDICAL DIRECTOR OF THE CARDIOVASCULAR SURGERY PROGRAM.”
Currently, HB 500 and 501 does not include the approval of medical director of cardiovascular surgery, and the Pennsylvania Medical Society believes that by including that physician, patient safety would be enhanced.
Regarding licensure of perfusionists, the Pennsylvania Medical Society does not oppose perfusionists being licensed by the state medical boards. We also do not object to having a perfusionist on the medical boards in the rotating slot for allied health professionals that are licensed by these boards. The perfusionist representative could fit into the rotation for that slot along with a nurse midwife, physician assistant, certified registered nurse practitioner, respiratory care practitioner and certified athletic trainer.
Lastly, perfusionists, we believe, should carry the appropriate amount of medical liability insurance.
Ultimately, the Pennsylvania Medical Society believes that both HB 500 and 501 with a few minor, but important, adjustments are good bills that will serve to improve health care in Pennsylvania. When physicians and others work as a team, patients benefit through checks and balances which promote patient safety. In fact, recent public opinion research conducted by the Pennsylvania Medical Society on the role of nurse practitioners suggests that the public believes this type of team work and patient safety measure is in their best interest.
According to our statewide public opinion research, the majority of Pennsylvanians (about 2/3rd) believe nurse practitioners should work under the supervision of physicians. In other words, they expect this type of patient safety measure and they expect a team approach to health care.
That’s why HB 500 and 501, unlike HB 700, is right on target in regards to scope of practice. Through HB 500 and 501, perfusionists would clearly be under the jurisdiction of medical boards. It allows perfusionists to work to their full scope by being specific about what they can do. And, the bills are very clear that perfusionists will perform “under medical supervision.” Thus, an important patient safety net is put in place that also helps to build a health care team.
HB 700, however, is vaguer on scope of practice issues and professional oversight of allied health care providers. The Pennsylvania Medical Society supports all health care workers practicing to the fullest extent of their training and education, but significant differences in education and training exist among doctors, nurses, physician assistants, midwives, and perfusionists. Reduced oversight and weakened collaboration removes the safety net of experienced, more knowledgeable providers and moves counter to a team-based health care approach. Quality and safety could be compromised.
Today, thanks to the efforts of the Pennsylvania Patient Safety Authority and the Pennsylvania Health Care Cost Containment Council, there is increased scrutiny of our health care professionals and systems to improve quality by avoiding medical errors as well as near errors.
As such, our state must take all patient safety issues seriously, and scope of practice is one area that should not be ignored. Health care works best when a team approach is used with appropriate oversight.
To conclude, the Pennsylvania Medical Society supports HB 500 and 501 with some minor adjustments. We believe the bills meet the needs of patient expectations. And, we believe that the bills would enhance both patient safety and health care teams.
Thank you.
Last Updated: 7/31/2008