Currently, 32 states and the District of Columbia at some point allow Nurse Practitioners to practice independently without a formal written practice agreement with a physician.
Some of these states allow nurse practitioners to practice independently as soon as they are licensed. Others allow for independent practice (also called Full Practice Authority) after a "Transition To Practice" period where a designated number of supervised hours must be completed prior to independent practice.
The remaining 18 states have no transition to practice period and require a nurse practitioner to have a written practice protocol with a physician to practice as an advanced practice nurse all of the time.
Therefore, many nurse practitioners must secure a collaborating physician to run their own clinic or private practice; it's a necessary business expense.
When choosing a collaborating physician, there are several important factors to consider to ensure a successful and productive working relationship.
Here's a list of 30 things to consider:
Medical Specialty: Ensure that the collaborating physician specializes in a field that complements your own.
Experience: Evaluate the collaborating physician's years of experience and track record in their specialty.
Reputation: Research the physician's reputation among peers, patients, and within the medical community.
Board Certification: Verify that the physician is board-certified in their respective specialty.
Licensure: Ensure that the collaborating physician holds a valid medical license in your state or region.
Location: Consider the proximity of the collaborating physician's practice or hospital to your own.
Availability: Determine their availability for consultations, meetings, and emergencies.
Communication Style: Assess their communication skills and compatibility with your own communication style.
Workload: Ensure that the collaborating physician has the capacity to take on additional responsibilities.
Collaborative History: Inquire about their past collaborations with nurse practitioners or other healthcare providers.
Practice Setting: Consider whether the physician's practice setting aligns with your own career goals.
Practice Size: Evaluate the size of their practice and patient population.
Billing and Compensation: Discuss billing and compensation arrangements, including revenue sharing and insurance participation.
Clinical Philosophy: Ensure that your clinical philosophies and approaches to patient care are compatible.
Hospital Privileges: Verify that the collaborating physician has privileges at the hospitals where you work.
Call Schedule: Discuss call schedules and responsibilities, including after-hours coverage.
Malpractice Insurance: Ensure that both you and the collaborating physician have appropriate malpractice insurance coverage.
Electronic Health Records (EHR): Determine whether their EHR system is compatible with yours.
Patient Demographics: Consider whether the physician's patient population matches your own target demographic.
Staff Collaboration: Assess their willingness to collaborate with your nursing staff and other team members.
Quality Metrics: Discuss quality improvement initiatives and how you'll measure success.
Continuing Education: Determine their commitment to ongoing medical education and professional development.
Conflict Resolution: Establish a process for resolving conflicts or disagreements.
Research Opportunities: Explore the potential for research collaborations, if relevant.
Referral Network: Assess the physician's referral network and ability to connect patients to specialists.
Cultural Sensitivity: Ensure that the collaborating physician is culturally sensitive and respects diversity.
Technology Adoption: Evaluate their use of technology for patient care, such as telemedicine or electronic prescribing.
Patient Satisfaction: Consider patient satisfaction ratings and feedback for the collaborating physician.
Contract Terms: Carefully review the terms of any collaboration agreement or contract.
Legal and Regulatory Compliance: Ensure that both you and the collaborating physician adhere to all relevant laws and regulations governing your practice.
Remember that choosing a collaborating physician is a critical decision that can significantly impact your career and the quality of patient care you provide. Take the time to thoroughly assess and discuss these factors before entering into a collaboration agreement.
