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NP - Physician collaboration, how does this work?
Posted on 7/3/14 at 7:43 am
Posted on 7/3/14 at 7:43 am
I'm an MD and an NP is asking for me to be her collaborater. How does this work? In general how much work is it? Is it worth it?
Please, both NP's and MD's respond.
And, before this gets out of hand, no pics
Please, both NP's and MD's respond.
And, before this gets out of hand, no pics
Posted on 7/3/14 at 7:48 am to white perch
they didn't teach that in that Caribbean med school?
Posted on 7/3/14 at 10:45 am to Motorboat
I didn't go to a Caribbean med school
Posted on 7/3/14 at 11:22 am to white perch
Not a clinician but work heavily in the healthcare space in consulting and IT. The collaborative agreement is all about defining the roles and responsibilities between the two practitioners. The communication, process and oversight pieces are key. A lot goes into the documentation and billing processes. Significant changes have to take place there to make the collaboration successful and compliant. What specifically are you wanting to know about?
Posted on 7/3/14 at 11:51 am to Scream4LSU
quote:
What specifically are you wanting to know about?
Success stories / horror stories
Do people find it enjoyable / fulfilling?
Posted on 7/3/14 at 11:57 am to white perch
Depends on the personality of the two. I've seen both success and failure. Failures are predominately related to not getting a clear cut agreement/process in place and sticking to it. Chart review is key to make sure the NP is delivering best practices care and the MD is providing a level of mentoring that is appropriate. The ones I've seen fall apart was ego related where the NP would not take direction very well or the Physician micro managed to a level it frustrated the NP and felt like he did not trust him/her.
Posted on 7/3/14 at 12:09 pm to white perch
You, the np, and your wife have an orgy every m, w, f.
Posted on 7/3/14 at 12:24 pm to white perch
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.
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.
Posted on 7/3/14 at 12:25 pm to white perch
quote:
NP - Physician collaboration, how does this work?
I'm an MD and an NP is asking for me to be her collaborater. How does this work? In general how much work is it? Is it worth it?
LINK
Posted on 7/3/14 at 1:53 pm to ForeverLSU02
quote:
ForeverLSU02
Not sure what you're trying to link to there.
Posted on 7/3/14 at 2:04 pm to white perch
Your state will define your relationship for the most part. I have some super successful clinics with this model in my region. There are several regular posters that can probably hook you up for a chat with similar providers.
Posted on 7/3/14 at 8:19 pm to white perch
Do you know her? Is she an intelligent individual? Can she distinguish sick from not sick?
This post was edited on 7/3/14 at 9:00 pm
Posted on 7/3/14 at 8:21 pm to white perch
I think Smackoverhawg works with them. I think they basically function like a 3rd year resident in any of your primary care fields. They can see some stuff on their own with minimal checkout/you not laying eyes on the patient, but for more complex stuff that you want to bill higher on, you have to walk in the room. I don't know how high they can code for or what actually requires any amount of oversight vs doesn't, though. But I'm hoping my typing that other username will get you the response you need, and I'm also trying to bump for you and not let it fall off the page.
Posted on 7/3/14 at 8:24 pm to Hopeful Doc
If the NP is just out of school you will need to provide training for a good year before she is able to be fully relied on.
Posted on 7/3/14 at 8:39 pm to saderade
You could collaborate with an Optometrist too.
Posted on 7/3/14 at 9:02 pm to Traffic Circle
quote:
You could collaborate with an Optometrist too.
What do you figure- another month or so of this, or do you just particularly enjoy posting it in medical threads enough to keep it up longer?
Posted on 7/3/14 at 9:43 pm to How I Roll
quote:
Do you know her? Is she an intelligent individual? Can she distinguish sick from not sick?
I do know her
Her patients think the world of her
She can tell sick from not sick
She's been in practice for about ten years
This situations a little different because she just started her own clinic (the clinic where she previously work is being shut down by the hospital that owns it). I don't directly work in that clinic. I would help set up protocols and be on call if she had a question during clinic hours.
I work two 24 hour shifts a week as an ER/hospitalist
Posted on 7/3/14 at 9:45 pm to white perch
quote:
What do you figure- another month or so of this, or do you just particularly enjoy posting it in medical threads enough to keep it up longer?
I respect the authority of the Legislatively-decided practitioners within the medical community. If you have a problem with these licensed practitioners, take it up elsewhere.
This post was edited on 7/3/14 at 9:46 pm
Posted on 7/3/14 at 9:46 pm to Hopeful Doc
Depends. Mine work under me directly in the same office. I review and sign off on all charts. I am readily available if they end up with something they don't feel comfortable handling. Even if I am out of the office, they can call me and even send images of xray, ekg etc for me to review. Technology is great(frick EMR though, y'all can keep that shite). I pay them a salary and have performance bonuses in place. Others may run their own practice and have a physician elsewhere to review and sign off on their charts. The fees here can vary widely. I've heard from a few thousand to up to a $100k. I would be quite hesitant to be the collaborating physician with a NP in a solo practice. They just don't know enough to practice solo, and what you are presented may not be an accurate representation of what was done. I have good NP's and they don't know shite compared to the average MD. It can be lucrative for both parties, but I prefer to be much more hands on than others docs may be. Like someone said earlier, I basically treat mine like a resident. Maybe more of a 1st year than a 3rd year though.
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