I am a legal nurse consultant and a Nurse Practitioner. The collaborating MD IS NOT LEGALLY LIABLE for the NP's actions. To prove malpractice a patient must prove the following 4 elements of negligence: 1. DUTY - the patient must prove that the MD had a duty to care for the patient. 2. BREACH of standards of care. 3. INURY to the patient. 4. CAUSAL RELATIONSHIP - the patient must prove that the negligence caused the patient's injury. If the Standardized Procedures, comprised by the NP & MD, clearly state the MD's role as a consultant only. Therefore, if the MD does not give any orders, does not co-sign any orders or prescriptions, and does not ever personally see the patient, then the MD never establishes "DUTY" to any of the NP's patients and therefore cannot be held liable. NPs must have collaborating MDs (not supervising or co-signing MDs) in 42 states to clearly recognize that the NP's scope of practice extends in part into medical practice. The Standardized Procedures are to establish that an MD is available as a consultant when the NP is in need of one while practicing medicine within a limited scope of practice. [in the other 8 states NPs are completely autonomous]