Page 21 - Part 2 Collaborating with Advanced Practice Providers - An Overview of State Rules

SVMIC Collaborating with Advanced Practice Providers

Control over the Treatment of Patients

What control should be exercised over the activity of advanced practice

providers in the treatment of patients? Nurse practitioners are generally

regulated and governed by the state board of nursing while physicians

and physician assistants are generally regulated and governed by the
state medical board and/or PA Committees. The boards give authority to

the physicians to exercise control over the APPs by requiring protocols,

collaborative agreements, delegation of prescriptive authority or other

provisions.

As outlined above, generally, physicians and APPs must jointly develop
customized, written treatment protocols (or a collaborative practice

agreement or CPA) that include a range of services within the provider’s

training, education and skill level.

The following case illustrates the potential for a supervising and/or

collaborating physician to be held accountable for acts or omissions of

the advanced practice nurse practitioner or physician assistant.

The Court found as follows: The Tennessee Supreme Court in Cooke v.

General Primary & Urgent Care Clinic first addressed whether a

Tennessee physician could be held liable for the negligence of physician

assistants whom the physician supervises. The court determined that
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physicians can be held liable for the negligent injury of a patient by

these physician assistants on the sole basis that the physician

supervises the physician assistant.

22 Cox v. MA Primary and Urgent Care Clinic. 313 S.W.3d 240 (2010)

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