Liability in CA

[juleswojo]

Hi all, I had a situation arise at work yesterday of which I am having difficulty figuring out the answer.

I work in a pediatrics office and I am the only NP, all other providers are MDs. I started this job in November '13.Yesterday my MA came to me with a sports physical form (nothing filled out besides a patient name) and asked if I could have this filled out by 4pm for the mother to pick up. This patient had been assigned to me but I had not yet seen her. Her well child checkup was done 6 months ago by the pediatrician who I replaced. I explained to the MA that since I had not done a physical exam on this patient, I did not want to fill out and sign a form saying I did, but I can squeeze them in this afternoon.

About 20 minutes later, I was pulled back to the assistant office managers office and again asked to sign the form. I again explained why I would not. She then asked me to review the visit note from the patient's well check up, fill it out accordingly, sign it and note that the exam was done by my predecessor. I asked who would then be liable for clearing the patient for school athletics and she didn't know. I told her I would like to find out the liability if I were to fill it out in that manor but until I knew I would not be signing it. After rephrasing the question a few more times with me continuing to refuse, the assistant manager sighed and said something about how she guesses they'll have to change the office protocols for me.

What do you all think? Not only did I not do the patient's physical, did not work at the office at the time, I was not even licensed in the state of california 6 months ago when the exam was done. (moved in from out of state, have been FNP for 3 years.)

If you made it to the end, thank you and I would love you feedback! I did not see any other threads with similar questions but if I overlooked it, please direct me!

[Corey Narry, MSN, RN, NP]

I don't work in Pediatrics and I'm and Adult Acute Care NP but I know for a fact that a well child check-up is NOT the same as a Pre-participation Athletic Evaluation (Sports Physical). I would absolutely, without a doubt, have done exactly what you did. Why risk your license by writing exam findings on a form with your signature and NOT touching a patient? It's bad enough to imagine the consequence if something gets missed on the physical and this kid ends up with sudden death while playing but you're basically committing fraud by filling out the form without seeing the patient. No matter how you slice and dice it, it makes me uncomfortable.

http://www.aafp.org/afp/2000/0501/p2683.html

[Corey Narry, MSN, RN, NP]

Trying to find California's rules on NP's doing PPE (Sports Physical) but not getting successful so far. Not all states allow NP's to do this independently. However, I found this link from a High School sports website in San Ramon, CA - says if an NP fills out the form, a "doctor" still needs to sign below NP's name. What does your Standardized Procedure say about you doing Sports Physicals?

Link: California High School: Athletic Packet

[juleswojo]

Juan, thank you for taking the time to respond. I had begun to wonder if I WAS being unreasonable. I also appreciate the link to the article on PPE which you provided. The sports physical form in this area (Monterey county) indicate that they may be filled out and signed by physicians, NPs and PAs so I have not been having a physician cosign.

Again, thank you!