Page 12 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

Collaboration Requires Communication

How closely must a physician interact with the supervisee?
Generally, the supervision must be “active and continuous” to

ensure that the physician is available and responsive to potential
patient care issues as well as the ongoing collaboration

and instruction for the APP. However, the supervisory or
collaborative relationship does not require the continuous

and constant physical presence of the physician. Most states
define supervision as overseeing the activities of and accepting

responsibility for the medical services rendered by the
supervisee.

The physician must be available to consult with the APP at all
times or must have an alternate physician available when

the primary physician cannot be made available. If a physician
is supervising or collaborating with a supervisee remotely, as

opposed to one that is employed as part of the physician’s own
practice site, the physician may be required to physically visit

the practice site.

Remote Practice Site

States have specific rules for oversight of APPs at a remote
practice location. If the APP practices at a remote site without

the physician’s presence, most states require that the written
protocol clearly specify the circumstances and provide written

verification of the availability of an approved physician. Often,
there will be requirements for remote practice site visits by

the physician as well. Many states require in-person quality
assurance meetings at defined intervals, usually quarterly. Some

boards must approve a specific written request describing the
services to be provided in the separate location, the distance

Page 12