Protocol · PA · District of Columbia
Practice Protocol for Physician Assistants in District of Columbia
Required. District of Columbia law names the instrument a Delegation Agreement, and the clinical protocol is the content that instrument carries. Below: the board that governs it, what it must contain, and the terms it has to carry.
DC has not adopted an experience-based autonomous-practice pathway for PAs (unlike, for example, Virginia's 2026 reform or North Dakota). A PA in DC needs an active Delegation Agreement with a supervising physician for as long as they practice.
What a District of Columbia Delegation Agreement must contain
Governed by the DC Board of Medicine and the DC Board of Pharmacy. Each numbered item is a statutory requirement the Delegation Agreement must satisfy.
The Physician Assistant ("PA") shall practice pursuant to a written Delegation Agreement with the Physician, as required by the DC Board of Medicine. The Delegation Agreement shall list every practice location and shall address the Physician Assistant's delegated prescriptive authority and duties.
The Physician and the Physician Assistant shall complete a documented quarterly Practice Advisory Review, maintained in the Physician Assistant's personnel file at the practice site.
- The Delegation Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Delegation Agreement has to carry, from District of Columbia's supervision rules.
Proximity
Available remotely (no on-site requirement)
17 DCMR § 4914 requires the PA to be under physician supervision at all times while practicing; the regulation does not set an on-site requirement or a mile or minute radius.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Quarterly
The PA and a supervising physician listed on the Delegation Agreement must complete a documented 'Practice Advisory Review' quarterly, kept in the PA's personnel file at the practice site (DC Health Delegation Agreement form; D.C. Code § 3-1204 framework).
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
The Delegation Agreement must address the PA's delegated prescriptive authority. Controlled-substance prescribing requires the supervising physician to delegate that authority and the PA to hold a DC controlled-substance registration plus DEA registration. The regulation does not spell out schedule-level limits; do not assume unrestricted Schedule II authority without checking the current Delegation Agreement form and 17 DCMR.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation or PLLC under D.C. Code § 29-508 (physician-owned; shares transferable only to physicians or the corporation)
This ownership question is distinct from the Delegation Agreement below, which governs clinical oversight of the PA, not who may own the entity the PA practices through.
Sources for the supervision rules (5)
- D.C. Code § 3-1204 — Board of Medicine authority over PA delegation agreements
- 17 DCMR § 4914 — Supervision (Physician Assistants)
- 17 DCMR § 4911 — Scope of Practice (Physician Assistants)
- DC Health — Physician Assistant Delegation Agreement form
- D.C. Code § 29-508 — Professional corporation ownership requirements (secondary-sourced summary)secondary
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, removing the collaboration mandate for every APRN category (NP, PMHNP, CRNA, CNM, CNS); DC is now a full-practice-authority jurisdiction for APRNs. PAs are not covered by that reform and still need a Board of Medicine Delegation Agreement regardless of experience.
Other clinicians in District of Columbia: see the state overview.