Practice Agreement · PA
Michigan Written Practice Agreement for Physician Assistants
Required. The Written Practice Agreement is the written instrument Michigan law names for a Physician Assistant working with a physician. 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 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 on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- MCL 333.17201statute
Public Health Code definitions of advanced practice registered nurse, registered professional nurse, and the practice of nursing.
- MCL 333.17211astatute
Grant of independent, non-delegated prescribing authority to an APRN for nonscheduled drugs, and the physician-delegation and dual-DEA-number requirement for Schedule 2-5 controlled substances.
- 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.
- MCL 333.16215statute
General statute allowing a physician to delegate acts, tasks, or functions to a qualified individual under the physician's supervision, provided the act does not require the physician's own level of skill or judgment.
- MCL 333.17744gstatute
Independent pharmacist authority, separate from any physician delegation, to prescribe and dispense self-administered hormonal contraceptives and emergency contraception, subject to Board of Pharmacy training and protocol rules.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state'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/physician isn't 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. Exact controlled-substance schedule limits were not independently confirmed in this pass — requires DEA registration.
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.
Legal sources for these 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.