I live in NC and it's true that we must have a "collaborating" physician but that doc does not need to be on premises or even involved in the practice to qualify as your "collaborating." He or she must be available (and designate another physician when he/she is not available) for consult which may be telephone, face-to-face, carrier pigeon, etc., for questions that may come up during patient care. NPs in NC may own their own practices, but must employ an MD/DO to be the collaborating physician of record. There is information about how frequently the NP and doc must meet to discuss a specific clinical issue (and a form for keeping track of these meetings) available on the NCBON website. A new collaborating relationship requires monthly meetings x 6 months, and then the meetings decrease to once every 6 months thereafter.
NPs in NC are governed by BOTH the BON and the Medical Board...and I believe that has a lot to do with money and control versus actual evidence based information concerning outcomes of patient care by NPs. And we have to pay annually for renewal of our collaborating relationship. And we have to pay for renewal of both the RN and the NP licensure (excuse me, but isn't the RN implied in the NP license?) so I believe lots of this is $$$ driven. In addition, the physicians so far refuse to allow JUST the BON to govern us. Not that the Medical Board actually does anything for us, but they seem to want to keep their hands in the the mix.