Morris M. Auster, Esq.                                                             Division of Governmental Affairs

Senior Vice President /                                                           MEMORANDUM  IN OPPOSITION
Chief Legislative Counsel 


                                                                                                                                  AN ACT to amend the public health law, in relation to the use of fluoroscopy by physician assistants

This measure would allow physician assistants (PAs) who have completed a training program approved by the Department of Education to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.    The Medical Society of the State of New York opposes this bill.

Fluoroscopy is an x-ray based technique that allows continuous imaging of an instrument, a body part, or a dye as each is used during a diagnostic or treatment procedure.  In a fluoroscopy procedure, an x-ray is passed through the body and the images transmitted to a monitor so that movement can be detected and evaluated.  It is used in cardiac, orthopedic, and other surgeries, in diagnostic studies, and in the placement of tubes in the body, such as peripherally inserted central catheter (PICC) lines.  Significant levels of ionizing radiation, however, may injure both the patient and the practitioner if safety precautions are not maintained.  Image quality and diagnostic utility may also be affected by the capabilities of the professional carrying out the technique.

Concerns over medical radiation exposure have received national attention in recent years.  Fluoroscopy accounts for approximately one-half of all clinical radiation exposure to the United States population, and continued growth in the use of fluoroscopy is expected.  As clinicians work to minimize radiation exposure of patients, a bill which would allow such exposure to be expanded seems counterintuitive.

While PAs are a very important member of the health care team, and can generally perform the functions delegated to them by their supervising physician, they are currently prohibited from performing fluoroscopy.   In our opinion, this is a patient safety issue.  Appropriate training and direct and/or personal supervision by the physician is particularly important in fluoroscopy because it has the potential to deliver large doses of radiation to patients during diagnostic and interventional procedures.  Until these changes are included in the bill, we must oppose its adoption.

For all of the reasons set forth above, the Medical Society of the State of New York opposes the bill and urges its defeat. 

                                                                                        Respectfully Submitted,

                                                                                          MSSNY DIVISION OF GOVERNMENTAL AFFAIRS