Advanced practice providers (APPs), credentialed as physician assistants and nurse practitioners, have had an increased presence in the work force over the past several years. Combined, there are more than 300,000 of these licensed providers in the United States, and they have made their way into more than half of urology practices (Med Econ 2015; 92:43-5; Curr Urol Rep 2015; 16:62).
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While training of these providers is relatively uniform, what differs dramatically under various state laws are the roles, responsibilities, and relationships between the provider and the physician. It is imperative that physicians know the law of the state they practice in with regard to their relationship with and responsibility for APPs providing urologic care.
There is rarely a malpractice suit where an NP or PA is named, and not a physician. This is due to the inextricable supervisory relationship between the physician and APP. The most common ways collaborating with an APP can land you as a named defendant in a lawsuit are negligent hiring/training of the APP and failure to properly supervise the APP.
Let’s take each one of these separately to highlight where the risk lies and what you, the physician, can do to prevent it.