Celebrating Nurse Practitioner Week: The Benefits of Collaborating with Nurse Practitioners

By: Nancy May-Skinner, Managing Attorney – The MLMIC Legal Department & Tammie Smeltz, RPLU, Content Marketing Manager

In today’s fast-paced healthcare landscape, nurse practitioners (NPs) have emerged as essential providers, offering a wide range of primary and specialty care services. In New York, NPs are increasingly being integrated into medical practices to enhance patient care, improve access and reduce healthcare costs. In fact, the number of licensed NPs in New York grew from 2,664 in 2019 to 4,182 in 2023.

A nurse practitioner is a registered professional nurse who has completed advanced education in nursing, either a masters or doctoral program. Education Law 6910. Nurse practitioners specialize in a wide variety of areas, such as family health, acute care, neonatology and women’s health.

A NP not only performs the normal duties of an RN, but they may also diagnose an illness or condition, perform therapeutic and corrective measures and prescribe medication within their specialty area of practice. Education Law 6902(3). An NP is an independent provider and does not need to work under the supervision of a physician. Id.  A written collaborative agreement may be needed depending on the NP’s experience. Currently, the New York State Education Law requires all NPs to practice in accordance with written practice protocols and a written practice agreement with a collaborating physician until the NP has 3,600 hours of clinical experience practicing as an NP pursuant to the laws of New York or another state or practicing as an NP while employed by the United States Department of Veterans Affairs, the United States Armed Forces or the United States Public Health Service. Once an NP completes 3,600 hours, they may practice without an agreement.

Benefits of Incorporating a Nurse Practitioner into Your Medical Practice

• Enhanced Patient Access: NPs can independently diagnose, treat and manage both acute and chronic diseases within their specialty area of practice . Education Law 6902(3). They can also perform routine check-ups and wellness visits. NPs also actively educate patients on health promotion and disease prevention. Implementing an NP into your office practice can lead to increased patient satisfaction, provider availability and decreased wait times.
• Increased Practice Efficiency: Implementing NPs into your practice can help free up physicians so that they can focus on patients with complex issues. NPs can manage a variety of tasks, such as assessments, medication management and referrals, leaving more time for physicians to handle patients with challenging medical conditions.

Collaboration with Physicians

For NPs who have less than 3600 hours of clinical experience, a written collaboration agreement with a physician is required.

The agreement must include the following provisions:

• Resolution of disagreements regarding diagnosis and treatment. Agreement should provide that if there is a disagreement between the providers, the collaborating physician’s diagnosis or treatment shall prevail.  If the agreement does not address disagreement, the collaborating physician’s view will prevail in any event. Education Law 6902(3)(a) and 8 NY ADC 64.5(a).
• Referrals, consultations and coverage are provided for emergency absences by the physician 8 NY ADC 64.5(a)(3).
• Review of patient records by the collaborating physician no less than every 90 days. Education Law 6902(3)(a)(iii).
• Written practice protocols that reflect current nursing and medical practice in the area of certification and are acceptable to the NYS Education Department.

Physicians cannot enter into written practice agreements with more than 4 NPs who are not located on the same physical premises as the physician. N.Y. Education Law 6902. There is no limit to the NPs being located on the same physical premises. Also, while a physician collaboration agreement with an NP does not by itself create a supervisory relationship, employment agreements could create such a relationship.

As we celebrate NPs this week, MLMIC extends its sincerest gratitude to NPs for their invaluable contributions to healthcare. Their dedication to patient well-being, combined with their clinical expertise, makes them indispensable members of the healthcare team. MLMIC is proud to support NPs and recognizes their significant impact on improving patient outcomes while decreasing healthcare costs.

MLMIC offers a valuable Continuing Education Program specifically designed to outline the role of NPs, as well as PAs, in healthcare. This program is available to MLMIC policyholders free of charge. For more information, please contact Matthew Lamb, Esq. at mlamb@mlmic.com.

MLMIC policyholders can reach our risk management attorneys for questions regarding the use of NPs or any other healthcare law inquiries by calling (800) 275-6564 Monday-Friday, 8 a.m. to 6 p.m. or by email here.

Our 24/7 hotline is also available for urgent matters after hours at (844) 667-5291 or by emailing hotline@tmglawny.com.

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If you are not already a MLMIC insured, learn more about us here.

Sources:

1. https://www.op.nysed.gov/professions/nurse-practitioners/license-statistics
2. https://www.op.nysed.gov/professions/registered-professional-nursing/laws-rules-regulations/article-139
3. https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-cost-effectiveness
4. https://www.npschools.com/blog/how-nps-decrease-healthcare-costs
5. https://www.op.nysed.gov/professions/nurse-practitioners/professional-practice/practice-requirements
6. N.Y. Educ. Law 6902
7. Education Law 6902(3)
8. Educ. Law 6902(3)(a)
9. 8 NY ADC 64.5(a)
10. 8 NY ADC 64.5(a)(3)
11. Education Law 6902(3)(a)(iii)

This document is for general purposes only and should not be construed as medical or legal advice. This document is not comprehensive and does not cover all possible factual circumstances. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors for any questions related to legal, medical or professional obligations, the applicable state or federal laws or other professional questions.