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Top 5 Things Nurse Practitioners Should Do If Operating a Medical Clinic With A Physician

 

#1:   OBTAIN YOUR OWN MALPRACTICE INSURANCE, POSSIBLY

  • Okay, so this is more of advice in case you have a complaint or lawsuit filed against you. It’s still good advice.
  • Check with your employer to see if their medical malpractice insurance covers you.
  • If your employer says you’re covered, then politely ask for a copy of the policy so you can see the extent of the coverage.
  • There are monetary policy limits on how much damages the insurer will cover.
  • You need to see exactly what is covered as well.
  • Does the policy cover negligence? How about lawsuits involving intentional torts (assault, battery, etc.)?
  • It may be to your benefit to obtain a separate policy in case there is a dispute as to liability between yourself and another medical professional if you are employed at a medical facility.
  • Also, check with medical malpractice carriers about obtaining supplemental coverage in case of a conflict with your partner physician, if you have one.

#2:   PARTNER WITH A SUPERVISING PHYSICIAN YOU TRUST

  • If you are planning on opening a medical care provider facility, you will need a supervising physician you trust.
  • Ideally, this should be someone with whom you have previously worked.
  • This should also be someone that you would have treat a loved one.
  • Make sure you discuss the option of having a secondary supervising physician available if the primary supervising physician has an emergency or is otherwise unavailable.

#3:   HAVE A GREAT COLLABORATIVE PRACTICE AGREEMENT

  • The collaborative practice agreement will have to adhere to the requirements set forth under 21 NCAC 32M .0110.
  • Your agreement will need to include what tests, procedures, medical treatments may be ordered and performed by you, the nurse practitioner.
  • The agreement shall include a pre-determined plan for emergency services.
  • Put in the agreement all quality improvement processes you and your primary physician will implement.
  • If you are going to prescribe and/or dispense medication, that needs to be in the collaborative practice agreement as well.
  • Drug and device prescriptions need to be consistent with the requirements of 21 NCAC 32M .0109.
  • If you and your physician partner are going to prescribe controlled substances, that must be stated in the agreement and both parties must be authorized by all relevant Boards to prescribe controlled substances.

*NOTE:  This is not a comprehensive list of everything you may need in a collaborative practice agreement.

#4:   FOLLOW YOUR COLLABORATIVE PRACTICE AGREEMENT

  • What’s the point in having a collaborative practice agreement if you’re not going to follow it anyways?
  • Make sure you review the agreement at least once a year. After all, reviewing an agreement at least once a year is required.
  • Keep in mind that you must meet with your physician partner every month for the first six months of your collaborative practice agreement.
  • Notes of ALL meetings must be made in writing, must be signed by all attendees, and kept by your office for 5 calendar years.

#5:   CREATE AND UTILIZE OFFICE POLICIES AND PROCEDURES

  • Policies and procedures for any business help alleviate guesswork and stress for the individuals in charge.
  • Nurse practitioners starting a medical practice with a supervising physician can create extremely useful policies and procedures that are in line with relevant statutes and administrative codes.
  • If staff has a question about something, written policies and procedures help them get their questions answered quickly and correctly.
  • Well written policies and procedures cut down on not only liability exposure, but staff time and your time as well.

*This list is not meant to be legal advice or to be a comprehensive list.  These are just examples of the more common things a nurse practitioner needs to know in order to open a successful medical clinic.

If you have any questions on this list or anything else please give North State Law a call at 919-521-8810.  Even if it’s not an area of law that we practice we know a lot of professionals to whom we can refer you.

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