Page 22 - Part 2 Collaborating with Advanced Practice Providers - An Overview of State Rules

SVMIC Collaborating with Advanced Practice Providers

CASE STUDY

In Cooke, a patient visited an urgent care clinic on several occasions

to be treated for respiratory problems and extreme fatigue. The urgent

care clinic was owned by a physician assistant, and the physician
assistant provided all care to the patient. The supervising physician

did not render any care at the clinic and did not have any ownership

interest in the clinic. After the patient’s condition worsened, the
physician assistant referred the patient to an unaffiliated

pulmonologist. The patient received care from several other providers
and was ultimately diagnosed with cardiomyopathy for which she

underwent mitral valve repair and mitral valve replacement surgery.
The patient filed a suit against the clinic and the supervising physician

for the physician assistant’s failure to diagnose the patient with

cardiomyopathy.

Because the patient sued the supervising physician, not the physician

assistant, the Cooke court was tasked with determining whether the
supervising physician could be held liable for negligence of the

physician assistant. The court determined that, yes, the supervising

physician could be held liable under Tennessee law even though the
physician assistant was not an employee and the supervising

physician did not have any ownership interest in the clinic.

Tennessee statutory provisions and the board rules convince us that,

as a general matter, a physician assistant stands in an agency

relationship with his or her supervising physician when the physician
assistant is providing authorized medical services within the scope of

the parties’ joint protocol. Thus, a supervisory relationship between a
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physician and physician assistant is enough of a basis on its own to

23 Cox, 313 S.W.3d at 254

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