re: NP - Physician collaboration, how does this work?

The collaboration between an MD and NP is not very well defined and varies according to a state's medical board.

It is kinda like what happens in a residency program, the residents can do basically everything, but have a staff member to oversee and monitor them.

Thus, a NP can do basically everything like primary care physician, but they need a collaborating physician to monitor, review, and sign off their work. An NP could operate his/her own clinic, prescribe medications, preform simple procedures and examinations as long as his/her physician approves the treatment plans. The NP usually give his/her collaborating MD a set feed every month. NP's usually operate in more rural areas. Thus, in some cases, a primary care physician may have 4+ NP.

While this arrangement may look like a pretty good deal... There are a lot of risks involved because the MD is ultimately responsible for what the NP does. On the medical board, we received numerous reports of NP's fraudulently billing Medicare/Medicaid, prescription abuse, etc...

Since the state medical board does not regulate NP's, we can only discipline the MD. A lot of times, the MD had no idea what their NP's were doing.