Doctors Influence Nurse Run Health Clinics
Nurse practitioners are prescribing medications more than ever before, with thousands of NPs and PAs operating outpatient clinics in Texas that no longer require a physician to be on site full time.
This change raises questions about the safety of these clinics, and researchers are studying the impact of physician oversight on nurse-led clinics.
Collaborative Care Models
Studies have shown that clinics with well-established oversight mechanisms have similar patient satisfaction and clinical outcomes to physician-led clinics.
However, when supervision is poorly structured or inconsistent, gaps in care can appear.
A key factor in successful collaborative care is the relationship between the nurse practitioner or physician assistant and the supervising physician.
For instance, when a collaborating physician reviews a random sample of patient records each month, prescribing errors can be significantly reduced, as this helps to prevent patients from encountering medication interactions or problems with dosing prior to administration.
Structuring the Relationship
In Texas, clinics are required to have a written agreement between the nurse practitioner or physician assistant and the supervising physician before services can commence.
This agreement outlines the frequency of review, actions for escalation, and prescribing limits, providing a safety check on clinical decisions.
The National Institutes of Health has found that structured collaborative agreements correlate with lower adverse event rates.
Vague agreements, on the other hand, are associated with higher adverse event rates.
Furthermore, the delegation of the physician is required for many categories of prescription, which is why a structured agreement is essential to ensure a safety check on clinical decisions.
Common Clinic Types
Clinics that rely on this collaborative model include those that provide medical weight loss and hormone therapy, hydrotherapy and wellness services, telehealth practices, and medical spas.
Related: Small meals or big – what’s healthier
These clinics carry a certain level of risk, which is why oversight rules are in place.
Securing a physician or partner can be a time-consuming process, which can delay the opening of a clinic and create a vacuum in care.
Faster matching services can help clinics connect with a licensed physician within days, rather than months.
This not only benefits the clinic but also provides patients with a better understanding of accountability and a paper trail for regulators.
Clinics that take the relationship with their supervising physician seriously are likely to have cleaner compliance records and fewer prescribing errors.
Patients should ask about the medical supervision of a clinic before beginning treatment, and clinic owners should prioritize constructing this relationship in a timely manner.
In fact, the degree of commitment that clinics give to this step also depends on the cost, and flexible pricing structures with no long-term contracts have opened the door for compliant oversight, especially for smaller and newer practices.
Additionally, when documents of oversight exist, that information provides a better understanding of accountability and provides regulators with a paper trail, should something go wrong.
Collaborative care is not a substitute for physician participation, but rather a system designed to maintain trained oversight and increase access to care.
It is essential for clinics to prioritize the construction of this relationship to ensure the provision of high-quality care and to minimize the risk of adverse events.
By doing so, clinics can maintain clean compliance records, reduce prescribing errors, and provide patients with a better understanding of accountability.
