Collaborative/Practice agreements

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This question goes out to the nurse practitioners who have worked or are working in medical groups with multiple physicians:

So I recently became certified as an NP (hooray!) in Pennsylvania. However, my education was lacking on the "how to's" post-certification. I accepted a job in an outpatient clinic that has three physicians. This office has never had a nurse practitioner before so they are beyond clueless about what I need to look like on paper. I finally got a practice agreement settled, and I am now moving on to the prescriptive authority end of it.

My question is; I will have one collaborating physician and two subs on my prescriptive authority and only one physician on my practice agreement (when I graduated I didn't even know there was a difference). Can I still see and care for the patients belonging to my substitute physicians? Or can I only see the patients belonging to my collaborating physician? Do I need separate agreements for each physician?

Any help would be greatly appreciated!!!!

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Specializes in Pain, critical care, administration, med.

I would call the BON. I am pretty sure you need an agreement with each doctor.

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Specializes in Family Nurse Practitioner.

Definitely call the BON it is whatever their requirement is and BTW what a disgrace that some schools aren't assisting NPs with this type of information prior to graduation. In Maryland we used to need only 1 Doc for each location, later only 1 Doc period that covered all locations where I worked and next month I won't need any. :)

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Specializes in Psychiatric Nursing.

Are you going to have your own panel of patients? Then I think you would have one collaborator. But yes ask the BON. There may be a document that spells out your responsibilities and frequency of mandatory meetings with your collaborator.

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Specializes in Cardiac, Home Health, Primary Care.

I work in a clinic with 5 MD's. They all see their own panel of patients and when they have time off they all see each others as needed.

I see mostly walk ins from ALL of the doctors. I only have an agreement with one MD and I usually consult with him if he is available. If I have a patient who has seen another MD for the last 10 years I'm going to go ask the PCP his opinion on the patient and if I'm not sure then consult with my collaborative MD.

It's still my practice and I'm not going to do something I'm not comfortable with regardless of who says that's what they would do. When I'm really not sure which way to go I make it a point to go to my collaborative.

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Specializes in Cardiac, Home Health, Primary Care.

Oh but it may vary by state. I am in Arkansas and our agreement basically says he reviews so many of my charts each quarter and is available (in person or by phone) when I am working

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Specializes in Vents, Telemetry, Home Care, Home infusion.

these links may help you:

21.285. Prescriptive authority collaborative agreements.

Collaborative Practice Agreement V.S. Application For CRNP Prescriptive Authority Defined

FAQs - Pennsylvania Coalition of Nurse Practitioners

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Definitely call the BON it is whatever their requirement is and BTW what a disgrace that some schools aren't assisting NPs with this type of information prior to graduation. In Maryland we used to need only 1 Doc for each location, later only 1 Doc period that covered all locations where I worked and next month I won't need any. :)

I was just reading today about Maryland's new law going into effect October 1. I am envious! :)

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