What is the recommended course of action if a PA disagrees with a supervising MD about a medication?

• A. Have a conversation with the supervising physician about concerns.
• B. Administer the medication anyway to avoid delays.
• C. Refuse to participate in the care plan.
• D. Consult legal counsel.

Answer: (A)

When a PA and supervising MD disagree about a medication, the best move is to talk through the concerns directly with the supervising physician. Open, professional communication helps safeguard patient safety and keeps care aligned with the team’s responsibilities.

Explain the specific concerns, review the patient’s history and current data, and discuss the risks and benefits of the proposed medication. Reference relevant guidelines, formulary policies, and alternative options, and suggest a plan that could satisfy safety and treatment goals. If the disagreement remains, follow the team’s escalation processes—such as seeking input from another clinician or a higher-level supervisor—and document the discussion and the final plan.

Administrating the medication despite the disagreement would bypass essential checks and could place the patient at risk. Refusing to participate without attempting to discuss and resolve the concern can undermine care and collaboration. Consulting legal counsel is not typically appropriate as a first step in clinical disagreement and can delay patient care.