Page 16 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

assistant is providing authorized medical services within

the scope of the parties’ joint protocol.” Thus, a supervisory
5
relationship between a physician and physician assistant

is enough of a basis on its own to find a supervising
physician vicariously liable for the negligence of a

physician assistant.

The Cooke case also is significant as the Supreme Court held
that the standard of care applicable to physician assistants is

distinct from that applicable to physicians. Further, because
the supervision regulations for physician assistants and

nurse practitioners in Tennessee are so similar, the reasoning
in Cooke would likely equally apply to the supervision of

nurse practitioners. Thus, this discussion and recommended
precautions should also be considered by physicians

collaborating with nurse practitioners.

Generally, nurse practitioners and physician assistants may
provide medical and/or surgical services as outlined in a written
protocol that are within their education, training, and skill

level (scope of practice). When evaluating scope of practice

and procedures delegated to the APP, the goal is to allow the
provision of services at his or her maximum level of training
and competency. The APP may perform procedures as outlined

in the protocol once all of the following have been met and

documented:

• Appropriate training and direct supervision (if required)

• Certification or credentialing if required

• Demonstrated competency

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

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