Page 30 - Part 1 Collaborating with Advanced Practice Providers - An Overview of State Rules

SVMIC Collaborating with Advanced Practice Providers

the management of patient care by supervision of, or collaboration
with, APPs. Understanding the regulatory responsibilities imposed

upon supervising and collaborating physicians and anticipating

the risks associated with oversight are important in avoiding

patient harm and the associated grave financial consequences,

regulatory sanctions and the headaches associated with litigation.

When a physician agrees to supervise or collaborate with an APP,
the physician takes on great responsibility, particularly when

physician supervision is the legal requirement in the practice state.

Most states have some statutory or medical practice act language

that suggests the physician is responsible for the actions of the

APP and that the physician has the duty of assuring that there is
proper supervision and control of the APP’s activities. Usually this

is accomplished by utilizing protocols, medication formularies,

periodic and defined practice site monitoring and competency

reviews.

Some physicians and APPs inaccurately view their legal

relationship as one in which the APP is required to have a

physician listed on the board application and the physician is

simply a necessary formality. Many physician-APP arrangements

do not define roles and responsibilities or involve regular

communication. This type of semi-formal relationship is risky to
both parties and may eventually lead to conflict. In fact, the

relationship should be one with well-defined roles and that is

mutually supportive, collaborative and accountable. Physicians

often do not realize the extent of collaboration necessary to keep

liability risk low.

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