working with NP

[scharnhorst]

Hi
Ive worked along with PA and NP but never "supervising" them.At my new job they want me to collaborate with 3 new NP
I have a healthy respect for the average mid level providers so I dont ask this question out of any prejudice or bias but what does the collaboration entail?
They are offering me a small fee per NP I work with
but does this mean
1- I review all their notes
2- are responsible for their patient errors? even if I never saw that patient with them
3-they have their own full schedules it is IMPOSSIBLE for me to review all their encounters
This job is at an FQHC outpt only

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[anthroguy]

if you have to sign off on their notes and/or they document that they consulted you on a particular patient you sure as hell better believe you have responsibility in this setting. Now depending on where you work, you may not need to review all their notes and only a subset so this may not be an issue.

I would keep track of any patients they bring up to you, ie drop a small blurb in the patients chart in case one of them gets in the habit of saying "spoke to Dr. X about this and he/she agrees with plan". I know this is slightly paranoid but I dont trust these arrangements.

 

[VA Hopeful Dr]

I'd be very leery of this, especially supervising 3. If they are paying you to do this, it means that you are responsible for everything they do. While I don't like the idea at all, I could see overseeing a single midlevel. Its a good bit of work if you want to do it well, but not the end of the world. Supervising 3 just seems like you're asking for trouble, especially given the complicated patients that tend to frequent FQHCs.

 

[deleted87716]

You'll definitely have some liability.

You'll need to research the laws in your state in order to understand what is legally required of a "collaborating" physician.

You'll need to assess the skill level of each of the NPs, and exercise your own judgement in terms of how closely they need to be supervised. If they're all "new NPs" (meaning fresh grads), look out.

 

[scharnhorst]

Thanks for the responses
I'm really scared now and want to back out of the contract, can I still do so ? My job is set to start in 2 weeks
What possible implications that might have ?
There are no financial or other penalties listed in the contract

 

[JustPlainBill]

Thanks for the responses
I'm really scared now and want to back out of the contract, can I still do so ? My job is set to start in 2 weeks
What possible implications that might have ?
There are no financial or other penalties listed in the contract

Get an attorney before you do anything -- do it quickly. I'm in a similar situation -- the practice (read -- the partners) suddenly decided that the employed physicians should be able to "supervise" the NPs/PAs when the supervising physician was out for whatever reason -- I now have direct responsibility for about 7 PA/NPs when their supervising physician is out of the building -- I pretty much went to each one of them and told them that I expected them to practice EBM when I was signing off on their plans -- that caused some squeals of pain but hey ---

My situation is usually not an issue -- I get about 5 charts per month and I've built up some trust with most of the PAs...NPs I inherently don't trust as a group since I've had really bad experiences with them...but I'm still wet behind the ears, practice wise, myself....

Again, get an attorney....

 

[Ericslv]

If you are considered the medical director of the clinic and they are considered providers that use you as a sounding board, then you are most likely responsible or at the lease carry a level of responsibility. In court that would mean you may be responsible.

There is still room to join the dark side.

 

[Doctor4Life1769]

If you are considered the medical director of the clinic and they are considered providers that use you as a sounding board, then you are most likely responsible or at the lease carry a level of responsibility. In court that would mean you may be responsible.

There is still room to join the dark side.

What's the dark side

 

[JustPlainBill]

What's the dark side

Not sure in this context -- but I'm told they have cookies....

 

[Bacchus]

What's an "appropriate" compensation? My network, to which I've humbly refused, asked me to supervise APCs as well. The offer was 5% of billed RVUs for NPs (as you only sign some notes/are available) and 10% of billed RVUs for PAs because you sign all charts. I'll be supervising residents and benefiting from their RVUs and seeing all their patients so I'm not taking on APCs.