Physician supervisors for California NPs?

[DrZaphod, BSN, MSN, DNP, RN, NP]

I can't find anywhere in the statutes or regulations that state the physician must be licensed in California, and there is no mention of geography or physical distance, other than to say it doesn't matter. Can I use a psychiatrist from, say, Iowa, as my physician "supervisor?"

[Leo87]

I can't find it either.

[Corey Narry, MSN, RN, NP]

The regulations do not explicitly require physical presence from a physician to comply with supervision requirements. It is up to the parties involved (NP and physician) to establish an arrangement that is agreed upon mutually in the standardized procedures (i.e., physician and NP may decide that a physician should be available in-house for NP's performing invasive procedures). No physical distance is stated by the law. Phone consults are perfectly acceptable. The regulations also state no requirement that the physician supervisor is licensed by the Medical Board of California.

In the example of the OP (physician is in Iowa acting as supervisor). While this appears to not violate any regulations, it is up for debate and further scrutiny in terms of how well this physician can perform the role of a supervisor being so far away physically to evaluate a patient should the need arise. In other words, you may get away with it but you are setting yourself up for a risky practice.

Please see FAQ's from the CA BRN: http://www.rn.ca.gov/pdfs/regulations/npr-i-25.pdf

[DrZaphod, BSN, MSN, DNP, RN, NP]

In many states, the idea of "supervisor" is basically a wink-wink, nod-nod type situation. You are right that there can be legal difficulties, but not from physical propinquity, as long as there is the ability to communicate (texts, emails, cell phone, etc). I spoke with the Board in California and they said use a MD/DO in California, but it does not matter physically where they are located, and it does not matter how often one speaks with them - this is all dependent on the Standard of Practice drawn up by the NP/MD/DO. Whatever that document says, goes.

I found one for $200 a month. Many are about $500. In most cases, the physician in question does not want to actually supervise or collaborate, and if the NP is experienced enough he/she probably doesn't care. It becomes a cost of independent practice, much like the utility bill. At least until NPs are given full autonomy in this state.

[lbmbushi]

What about a specialty? Can a PMHNP be supervised by a Family Practice MD?

[Corey Narry, MSN, RN, NP]

What about a specialty? Can a PMHNP be supervised by a Family Practice MD?

Can you explain the scenario a bit clearer? Does the standardized procedure allow the PMHNP to perform FP roles since this is the physician's specialty or does the standardized procedure state that the FP physician is overseeing the PHMNP's clinical activities as a mental health provider?

Either way it's very sketchy to me. The regulations does not have to be specific for a provider to throw common sense and astute risk management out the window. In either scenario competence will be a huge issue. California does address clinical competence in its regulations and this is in the FAQ I posted a link to in my post above.