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To function across numerous state lines, supervisory relationships are a prerequisite. Additionally, practicing authority varies from state to state, with some providing independent authority for treatment and prescription, and others restricting particular specializations, like nurse practitioners, to practice only under strict physician supervision and collaboration.
Why is a collaborative practice agreement necessary?
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Many states want some kind of medical oversight before granting the full ability to examine, diagnose, treat, and prescribe medication. State-specific requirements for supervision levels range from regular in-person meetings to chart review quotas to prescription/protocol review. Such requirements may be temporary until full practice authorization is obtained or they may be ongoing to maintain a state license.
A nurse practitioner will most likely need to enter into a collaboration agreement to provide treatment in a particular state to hold multiple state licenses.
What is a collaborative practice agreement?
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A written agreement known as a "collaborative practice agreement" outlines how the doctor and nurse practitioner will collaborate. This frequently entails that the doctor will supervise, direct, and be accessible for conversations with the nurse practitioner.
For nurse practitioners, there are three degrees of practice authority:
Full practice: The nurse practitioner is allowed to operate independently and offer clinical care, which includes assessing clients, ordering and interpreting tests, starting and maintaining treatments, and prescribing medicines.
Reduced practice: The nurse practitioner can do some services on their own, but all other aspects of client care require a collaborative arrangement with a doctor.
Restricted practice: The nurse practitioner is not allowed to do one or more aspects of clinical practice.
The activities that fall under each nurse practitioner's scope of practice should be covered in a collaborative practice agreement, such as the services that can be provided, the conditions that can be treated, the services and conditions that require a physician's consultation, the nurse practitioner's ability to order, perform, or interpret lab tests, and the nurse practitioner's ability to prescribe and manage medications.
Which states demand medical supervision?
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State-by-state regulations requiring collaboration agreements change often as a result of the pandemic.
How do nurse practitioners find a doctor to collaborate with?
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One of the most effective strategies to establish a cooperative relationship is frequently word of mouth.
By asking around in social media groups, attending live and online industry events, joining networking organizations, and connecting on LinkedIn, many nurse practitioners can connect with physicians who share their interests.
Once you've found a collaborator, you must put your arrangement in writing by creating a collaboration agreement. Templates for collaboration agreements are available from numerous state nursing boards or state professional nursing societies.
What is the role of the collaborating physician?
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While each state has its own specific rules for a collaborative relationship, clinical care cannot be provided by a nurse practitioner without some form of physician oversight or engagement.
Consultations with the nurse practitioner, answering queries, reviewing client records, establishing diagnoses, requesting testing, and writing prescriptions are all examples of physician services.
Usually, the doctor receives a set annual charge, an hourly rate, or a combination of the two. The time commitment and particular conditions of the agreement determine how much the doctor gets paid.
What are the risk and protection for physicians who collaborate?
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Many participating doctors worry about responsibility. After all, the doctor overseeing the nurse practitioner could be held accountable for malpractice if they make a mistake and are sued.
In general, a cooperating doctor's liability exposure is comparable to that of any CEO or healthcare professional that manages other practitioners. In many places, collaborating physicians are either protected from accountability for the deeds of their associate nurse practitioners or there is uncertainty as to whether the collaborating physician might be held accountable in these situations.
A few states, nevertheless, hold collaborating doctors accountable for the conduct of the nurse practitioners they supervise.
Physician collaborators should be in addition to the supervision duties mandated by the state board of nursing.
Nurse practitioners should be aware that, depending on their setting of practice and the services they offer, they might require medical supervision when treating clients. Because laws can change, it's crucial to confirm that you are abiding by the rules in your state. Nurse practitioners will be well-positioned by locating a partnering physician, setting up a collaborative practice agreement, and making sure the physician has enough liability protection.
We know how challenging it is to launch your business or private practice and not have a physician that is affordable, reliable, supportive, and available. This self-paced Collaborative physician network will teach you everything you need to know about finding collaborative or supervising physicians and medical directors in their state.
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