Protocol · PA · Michigan
Practice Protocol for Physician Assistants in Michigan
Required. Michigan law names the instrument a Written Practice 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.
No independent-practice or experience-based autonomy pathway exists for PAs in Michigan — a written practice agreement with a participating physician is required for as long as the PA practices (MCL 333.17047-333.17048).
What a Michigan Written Practice Agreement must contain
Governed by the Michigan Board of Medicine and the Michigan Board of Pharmacy. Each numbered item is a statutory requirement the Written Practice Agreement must satisfy.
The Physician Assistant ("PA") shall practice pursuant to a written practice agreement with the Physician, as required by MCL 333.17047. The agreement shall address the process for communication and availability between the Parties utilizing each Party's education, training, and experience; decision-making responsibilities; a protocol designating an alternate physician when the Physician is unavailable; delineation of duties consistent with the Physician Assistant's training; and a termination clause permitting either Party to terminate the agreement on at least thirty (30) days' written notice.
Source: MCL 333.17047
Michigan law does not fix a numerical limit on the number of Physician Assistants with whom a physician may enter into a practice agreement. The Michigan Board of Medicine retains rulemaking authority to restrict delegation of high-risk medical services or to restrict which drugs a Physician Assistant may prescribe, and unsafe delegation remains a ground for licensure discipline.
Source: MCL 333.17048
- The Written Practice Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Statutes and rules these clauses cite
- MCL 333.17047statute
Mandatory practice-agreement requirement and content for physician assistants: communication/decision-making process, alternate-physician protocol, signatures, 30-day termination notice, and delineation of duties.
- MCL 333.17048statute
Board of Medicine rulemaking authority to restrict delegation of high-risk services and to restrict which drugs a PA may prescribe; no numerical PA-per-physician ratio appears in the current text.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Written Practice Agreement has to carry, from Michigan's supervision rules.
Proximity
Available remotely (no on-site requirement)
Michigan's statutory 'supervision' standard (as applied to delegated practitioners generally) requires continuous availability of direct communication and regularly scheduled record review/consultation — no on-site or fixed mile/minute radius is codified for PAs.
Supervision ratio
Up to 4 at a time
A physician who is a sole practitioner, or who practices in a group and treats patients on an outpatient basis, may not supervise more than 4 PAs at one time (MCL 333.17048). The statute does not extend this cap to hospital-based settings the way the outpatient text is worded — confirm applicability before assuming it's universal.
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
The practice agreement must define delegated duties, excluding any task the PA or physician is not qualified to perform. The Board of Medicine may prohibit or restrict delegation of, or require higher supervision for, services that pose serious risk or require extensive training. Requires DEA registration; schedule-level limits are not spelled out.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation or Professional LLC — a PA who is a shareholder/member must disclose whether any physicians (MD/DO/DPM) are also shareholders/members. Since July 19, 2010, PAs may NOT organize a PLLC with only PAs as members — some physician/podiatrist involvement in ownership is required (MCL 333.17048).
This ownership question is legally distinct from the clinical practice agreement above.
Sources for the supervision rules (3)
About Michigan's rules
Michigan has no independent-practice pathway for NPs, CNMs, CNSs, or PAs — specialty certification alone never grants autonomous practice, and delegated authority is renewable/revocable rather than a one-time threshold. CRNAs may deliver anesthesia care independently within the perioperative period but must still maintain a collaborating physician/dentist/podiatrist relationship. A PA-only PLLC has been prohibited since 2010.
Other clinicians in Michigan: see the state overview.