Independent Practice Authority for Delaware Physician Associates 

This article is part of a series on Delaware’s new Physician Associate Act. Start with Delaware’s New Physician Associate Act: What Changed and Who It Affects. 

A physician associate who has practiced in Delaware for several years and is considering what comes next now has an option that did not exist a year ago. House Bill 325, signed May 12, 2026, permits a physician associate with sufficient clinical experience to seek authority to practice without a collaborating physician. 

The question that follows is a practical one: who qualifies, how does the application work, and what does the authority actually change? The threshold is specific, the application runs through a body most physician associates have never dealt with, and the authority does somewhat less than the coverage of the new law suggests. 

Collaboration remains the default 

Except in a medical emergency or as otherwise provided, a physician associate may not perform any medical act without a collaborative agreement, and nothing in the chapter authorizes a physician associate with fewer than 6,000 post-graduate clinical hours to practice independent of a collaborating physician. (24 Del. C. § 1772.) 

There are exactly three exceptions. 

1. Independent practice authority, discussed below. We refer to it throughout as “independent practice authority” or “IPA.” 

2. Uncompensated volunteer or charitable care, which may be rendered without a collaborating physician, or with such collaborating physicians as are available. (24 Del. C. § 1774E.) 

3. A medical emergency. 

That is the complete list. Seniority alone does not qualify a physician associate to practice independently, and neither does an employer’s willingness to operate without oversight. 

What independent practice authority requires 

More than 6,000 post-graduate clinical practice hours. Below that threshold, independent practice is expressly unauthorized and there is no discretionary waiver. For a physician associate practicing full time, the threshold generally arrives somewhere around the three-to-four-year mark, although part-time and intermittent practice will extend that considerably. 

An application to the Regulatory Council for Physician Associates. A qualifying physician associate who intends to practice without a collaborative agreement must apply, and the Council verifies the hours. 

One of two application tracks. Which track applies matters more than it initially appears. 

1. Practice in a setting with at least one licensed Delaware physician in the group, practice, or health system. 

2. Practice in a setting without such a physician. This track additionally requires proof that the physician associate has had training which aligns to the physician associate’s practice areas. 

Both forms require the physician associate’s name, license number, practice location, contact information, primary practice area, and proof of the required hours. In addition, a physician associate who later changes practice areas must notify the Council beforehand, again with proof of aligned training. 

The second track is the one that matters for a physician associate planning a solo practice or a practice without a physician in the group, and it carries the additional documentary burden. 

When applications can be filed 

House Bill 325 was signed on May 12, 2026. Although the Act carries a May 12, 2026 effective date, the new independent-practice framework is not fully operational until the earlier of Board approval of implementing regulations or May 12, 2027. 

Those regulations have not been adopted as of the date of this article. Thus, the application forms described in the statute do not yet exist in usable form and no physician associate can presently file. The outside date is May 12, 2027, though the regulations may issue sooner. 

What independent practice authority does not do 

• It does not end the duty to consult and refer. Every physician associate, whether or not he or she holds independent practice authority, must collaborate with, consult with, and refer to the appropriate member of the healthcare team as indicated by the patient’s condition and by the physician associate’s own education, experience, and competencies. Independent practice authority removes the collaborative agreement; it does not remove the underlying obligation of clinical judgment, and it does not alter the standard of care. 

• It does not displace the license. A physician associate’s authority flows entirely from the Chapter 17 license. Treating a Delaware patient constitutes practice “in this State,” and unlicensed practice as a physician associate is a criminal offense carrying a fine of $500 to $2,000, imprisonment of up to one year, or both. (24 Del. C. § 1774B.) This is most easily overlooked by physician associates practicing remotely, who may assume that their physical location governs. It does not. 

• It does not by itself authorize a physician associate to own or operate a practice. Ownership of a practice entity and authority to practice independently are related but distinct questions, and Section 1772 contains a provision concerning the maintenance or management of a practice location that reaches physician associates who have not obtained independent practice authority. A physician associate planning to practice through his or her own limited liability company should review that provision before forming anything, and we address it in detail in the telehealth and entity structure article. 

A note for physician associates re-entering practice 

A physician associate returning after more than three years away from practice, including one who was practicing in another United States jurisdiction, may be subject to Board-imposed re-entry conditions. Those conditions may include requiring the collaborating physician to be physically on site while the physician associate is practicing. (24 Del. C. § 1774D.) 

An on-site requirement will foreclose remote practice for as long as it remains in force. A physician associate planning a telehealth practice after time away from Delaware should therefore resolve this question before building a practice model around remote delivery. 

What can be done while the regulations are pending 

Although no application can be filed today, the preparatory work is entirely documentary and can begin immediately. 

1. Assemble documentation of clinical hours. Verification is the Council’s responsibility, but assembly is the applicant’s, and reconstructing several years of clinical hours after the fact is considerably more difficult than exporting the records while system access to a current or former employer remains available. Physician associates who have changed positions more than once should begin here. 

2. Map training records to intended practice areas. For a physician associate who plans to practice in a setting with no Delaware physician in the group, the aligned-training requirement is, on the statutory language, the item most likely to delay an application. Continuing education certificates, specialty training records, and procedure logs are all more easily gathered now than under a filing deadline. 

3. Consider the practice area designation carefully. Because a later change in practice areas requires advance notice to the Council together with fresh proof of aligned training, the designation on the initial application is not a formality. 

TIP: If a change in employment is contemplated in the next year, gather the hour documentation before giving notice. Former employers are generally cooperative, but requests made after a departure move more slowly than requests made before one. 

Conclusion 

The qualifying threshold is hours, the gatekeeper is the Regulatory Council, and the preparation is documentary, which means it can be substantially completed before the application process opens. 

Physician associates considering independent practice, and particularly those contemplating a practice with no physician in the group, are advised to review both their documentation and their intended practice structure with counsel before the regulations issue, because the entity and licensure questions are more closely connected than they first appear. 

Also in this series: [Telehealth, Limited Liability Companies, and Independent Practice] and, for employers, [how the four-physician-associate collaboration cap works]. 

Andy Silverman is a partner in the Business Department at MacElree Harvey, Ltd. He advises medical practices and providers on business structure and governance, equity and physician compensation arrangements, employment agreements, private equity and M&A transactions, and regulatory and tax matters. Admitted in both Delaware and Pennsylvania, he holds an LL.M. in Taxation from Villanova University School of Law and is a member of the American Health Law Association. 

This article reflects Delaware law as of August 4, 2026. The Regulatory Council’s implementing regulations had not been adopted as of publication. 

This article is for general informational purposes and does not constitute legal advice or create an attorney-client relationship. Attorney advertising.