Do NP's work under MD's?

SebagoLaurel · May 2, 2006

I believe it depends on which state you are in. In MA, NP need to be associated with or work under a physician. But I think in other states (NY?) they can be independant.

Psychaprn · May 17, 2006

I believe it depends on which state you are in. In MA, NP need to be associated with or work under a physician. But I think in other states (NY?) they can be independant.[/
In Ct. I am a Psych. APRN/NP. I am required to have a COLLABORATIVE RELATIONSHIP with the Psychiatrist. We meet once a month and I ask him questions anytime prn-keep him abreast of the pt.s I treat prn-otherwise independent.

yellow finch, BSN, RN · May 18, 2006

Here in GA, NPs are still considered Physician Extenders just as PAs. Since we just got prescriptive rights it'll probably be a looooooong time before we're working independently.

christvs, DNP, RN, NP · May 18, 2006

Here in GA, NPs are still considered Physician Extenders just as PAs. Since we just got prescriptive rights it'll probably be a looooooong time before we're working independently.

I didn't know Georgia NPs could prescribe. Did that just happen recently? That is so awesome!! :)

christvs, DNP, RN, NP · May 18, 2006

I believe it depends on which state you are in. In MA, NP need to be associated with or work under a physician. But I think in other states (NY?) they can be independant.

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Hello! I live right near you-in Worcester. Are you an NP or a student NP? I just started the MSN program at UMASS-Worc. I'm taking an elective class now and will be full time in the fall. Just wanted to say hello. :)

-Christine

ERNP · May 18, 2006

I never work under the MD, he is much too heavy!! However, working in the ER an MD does sit beside me, about 6 ft away. I see my patients, he sees his patients, and sometimes one or the other of us will look at each other and say...."Hey what do you think about......?" It all works out very well.

I do have friends who practice mostly independently in the office setting, but a lot of states require a collaborative relationship, sometimes a supervisory relationship with a physician.

There are a couple of states, seems like they are in the West, maybe Washington or Oregon, and possibly Alaska that allow complete independence. Or at least I think I read that somewhere.

MikeyJ, RN · May 20, 2006

I am not an NP, but I come from Michigan, and in Michigan NP's can work alone (I believe), and in fact in most areas of Michigan, the NP's are highly utilized. They may have to have a collaborative relationship though.

However the state laws work, most NP's have a great deal of independence. Even if they have to "work under" an MD (which I honestly don't necessarily see as a bad thing), the relationship is usually understanding and the NP usually has a great deal of independence and only consults the MD as needed. As a previous poster said, the NP and MD/DO usually meet up once or twice a month to discuss patients.

Jengirl18 · May 20, 2006

I agree sistermike. I don't understand why NPs are so hipped on not wanting to "work under the doctor." It would make them more marketable if they are willing to work in a more collaborative way instead of independent, and it would give the patient the best outcome.

yellow finch, BSN, RN · May 21, 2006

I didn't know Georgia NPs could prescribe. Did that just happen recently? That is so awesome!! :)

Yep! It happened about a month ago though I'm not certain when it will take effect. As long as it happens before I graduate (in 2 years).

Psychaprn · May 22, 2006

I am not an NP, but I come from Michigan, and in Michigan NP's can work alone (I believe), and in fact in most areas of Michigan, the NP's are highly utilized. They may have to have a collaborative relationship though.
However the state laws work, most NP's have a great deal of independence. Even if they have to "work under" an MD (which I honestly don't necessarily see as a bad thing), the relationship is usually understanding and the NP usually has a great deal of independence and only consults the MD as needed. As a previous poster said, the NP and MD/DO usually meet up once or twice a month to discuss patients.

Sorry, but not all MD's that work "over" an NP are understanding-working under is a denigrating way of putting it anyway-professionals are supervised or collaborated with. That's why I wouldn't want to be a PA-who wants to be seen as the Dr.'s assistant? I like being a person who practices nursing, like an attorney practicers law. Although, practices is kind of silly isn't it? it implies that you're not quite competent yet so you keep practicing! When I worked with another MD his elderly patient's assumed I "helped" him and was his wife! He didn't say a word-I had to clarify my role for the patients!

Psychaprn · May 22, 2006

I agree sistermike. I don't understand why NPs are so hipped on not wanting to "work under the doctor." It would make them more marketable if they are willing to work in a more collaborative way instead of independent, and it would give the patient the best outcome.

If you had 25 years of experience in your field, the education to be an NPand the ability to prescribe don't you think it would be a little demeaning to work "under someone? " Collaboration can still mean independence-I consult with an MD asnd appreciate his kowledge as does he, mine. There's no evidence patient outcomes are better when NP's work with an MD versus a private practice. Actuall y, I've never had a pt. say an NP gave them bad care so they went to an MD but I certainly have heard the opposite!