Nurse practitioners are advanced-practice nurses who can diagnose and treat patients as well as prescribe medications. Depending on which state they work, they may work independently of physicians.

In some states, a collaborative agreement may be required for a nurse practitioner to practice. This agreement is a document that establishes a "joint practice" between the NP and MD. It usually includes:

  • The parties involved
  • Date of initiation of the agreement
  • The scope of practice of the NP with regards to diagnosing, treating, and prescribing (specific scope of practice is regulated by each state)
  • Documentation review requirements
  • Physician availability requirements

Based on the state of practice, the amount of time closely spent with an MD is variable. Some states allow NPs to practice and prescribe independently, and they can even open and run their medical clinic. Other states require physician oversight and periodic documentation review. Some states require physicians to be on-site while others allow for telephonic consultation.

Regardless of state requirements, nurse practitioners should feel comfortable collaborating with physicians if needed. For example, if faced with a challenging case, the NP should collaborate with a physician to ensure the proper treatment is rendered. For the most part, nurse practitioners and physicians have a cohesive, respectful relationship. Physicians appreciate the high-quality care they deliver to patients, as well as the assistance they provide to an MD's practice.

Specifically, some of the components of care the nurse practitioner may collaborate with the physician on, whether related to the scope of practice or not, may include:

  • Test result interpretation and actions needed
  • Physical exam findings
  • Medication prescribing
  • Clinically unstable patients

The items listed above are just a few reasons why an NP would collaborate with a physician. Sometimes, nurse practitioners "pick the brain" of physicians for learning purposes. Physicians have encountered many experiences in their career, and nurse practitioners find that learning about case studies and physician experiences enhance their practice.

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