Physician Owed Duty to Nurse Practitioner’s Patient

[Taurus]

The Indiana Court of Appeals recently held that a physician, who entered into a collaborating practice agreement (CPA) with a nurse practitioner, had a duty of care to the nurse practitioner’s patient even though the physician never treated or saw the patient. - See more at: http://www.natlawreview.com/article...e-practitioner-s-patient#sthash.LmJlqEDF.dpuf

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[Taurus]

This is why I would never enter any collaborative agreement with a NP.

If anybody works under my license, I'm supervising them very closely.

If NP's want to independently, then they can do it under their licenses. I don't want to be there when the **** hits the fan because they don't know what they are doing.

 

[gutonc]

Look man...we know your approach here. But did you even read the article (or the complaint)? Because this was an individual doc who entered into this agreement, presumably for financial reasons. And he admits he didn't review charts (I'm going to assume the CPA stated that he would, although I recognize this may not be the case). Sounds like a typical lack of supervision/looking to make bank situation. He gambled and lost.

 

[Doctor4Life1769]

He was only obligated to see 5% of weekly charts.
Let's say he did follow the rules, but that particular chart was not selected as one of the 5%, would he still be screwed?
He fessed up to his sins, which is good but ultimately cost him.

 

[Doctor4Life1769]

Look man...we know your approach here. But did you even read the article (or the complaint)? Because this was an individual doc who entered into this agreement, presumably for financial reasons. And he admits he didn't review charts (I'm going to assume the CPA stated that he would, although I recognize this may not be the case). Sounds like a typical lack of supervision/looking to make bank situation. He gambled and lost.

If the chart was not one of 5% and if he had lost despite following the rules, then there is no benefit to this CPA model. One would have to review EVERY chart. Plus, what kinda NP prescribes multiple opiates and benzos like that??

 

[gutonc]

He made his bed. I hope he made enough money off the deal to make it worth lying in.

 

[Doctor4Life1769]

He made his bed. I hope he made enough money off the deal to make it worth lying in.

You didn't answer my Q.

 

[calvnandhobbs68]

They just want to sue him bc the NP is no longer with us (I know, I know, not really).

http://www.jessenfuneralhome.com/obits/obituary.php?id=500894

 

[gutonc]

You didn't answer my Q.

I assumed it was rhetorical.

All of them.

 

[gracie369]

"Barger prescribed her patient, Robert Ratts, multiple medications, including Lortab, methadone, Wellbutrin, lithium and Xanax."

Could of just went with a propofol drip! Jeez. But the triglycerides though, I know.

 

[gutonc]

Let's say he did follow the rules, but that particular chart was not selected as one of the 5%, would he still be screwed?

Maybe. Probably.

Again, he agreed to this CPA, presumably of his own free will. If he didn't read the contract and didn't realize that he'd be responsible in a situation like this, he needs a better lawyer (to sue the one that reviewed his contract, for legal malpractice).

 

[RadOncDoc21]

I agree with the decision. The most important thing we were taught was that the attending physician is 100% responsible for the patient's care.

I'm sure he gained financial incentives having the NP practice under his name.

 

[deleted480308]

I agree with the decision.

I also have thought collaboration agreements were a bad idea and no intention of being in one.

 

[Doctor Bagel]

He was only obligated to see 5% of weekly charts.
Let's say he did follow the rules, but that particular chart was not selected as one of the 5%, would he still be screwed?
He fessed up to his sins, which is good but ultimately cost him.

If this np was practically as ridiculously as it sounds like, I would hope he would have figured that out after reviewing a small sample of her charts. It sounds like he decided to profit off a NP who needed him to run her drug dealing clinic (from the description of these medications, I'm guessing she was a pill mill person). Those clinics are hard to miss, especially if you're theoretically supposed to be supervising them.

 

[Doctor4Life1769]

If this np was practically as ridiculously as it sounds like, I would hope he would have figured that out after reviewing a small sample of her charts. It sounds like he decided to profit off a NP who needed him to run her drug dealing clinic (from the description of these medications, I'm guessing she was a pill mill person). Those clinics are hard to miss, especially if you're theoretically supposed to be supervising them.

True.
As a physician, it was a stupid move to try to profit off a pill mill.

 

[Daiphon]

"Barger prescribed her patient, Robert Ratts, multiple medications, including Lortab, methadone, Wellbutrin, lithium and Xanax."

Could of just went with a propofol drip! Jeez. But the triglycerides though, I know.

How'd the methadone fly? NP's aren't granted that prescribing authority... could be how/why they nailed the collaborating physician... if he was signing scripts without review, he's a twit.

Semper Brunneis Pallium

 

[Psai]

Man with all the horrible consults I'm getting from nps, I can't understand why they are allowed to do anything

 

[gutonc]

How'd the methadone fly? NP's aren't granted that prescribing authority...

This may be state dependent but methadone for pain management absolutely can be Rx'd by NPs and PAs...at least where I live. My palliative care NP uses it all the time.

Now for opioid addiction maintenance therapy...that's a different story.

 

[Daiphon]

This may be state dependent but methadone for pain management absolutely can be Rx'd by NPs and PAs...at least where I live. My palliative care NP uses it all the time.

Now for opioid addiction maintenance therapy...that's a different story.

Fair point. Wasn't thinking about palliative or pain management; was thinking about opioid maintenance. Still scary though.

-d

Semper Brunneis Pallium

 

[mimelim]

I don't see anything wrong with how this was handled by the courts... Pretty open and shut case... To be honest, having a hard time deciding which is worse, what the NP did or what the MD did.

 

[DrMason]

This doctor was either naïve, uninformed or plain stupid. Maybe a combination of all three. If you enter a workplace where a "midlevel" exists, you better know what your contract says. Hospitals and groups LOVE to do this. It protects THEM from having to cover a NP's mistakes since the "supervising physician" should have noticed it.

He most likely did it to get some fast bucks. If you were Picasso, would you let a painter with some community college finish your last work?

Didn't think so. This was idiotic choice.