Physician Rights and Responsibilities Regarding Collaboration with Non-Physician Practitioners

Resolved Section(s):
RESOLVED: That MSMS update existing policy, “Standards for Collaborative Agreements,” to recognize that the decision to collaborate must be made voluntarily, not as a condition of employment, and with a formal collaborative practice agreement; and be it further RESOLVED: That MSMS support legislation or regulation to ensure that the employers of nonphysician practitioners have the financial and administrative responsibility to provide work and staffing conditions that offer (1) a safe level of collaboration in the independent medical judgment of the collaborative physician and (2) timely and safe level of oversight in the independent medical judgment of on-site physicians who may be asked to verify with or without attestation to medical acts of the nonphysician practitioner; and be it furtherRESOLVED: That MSMS seek and support legislation regarding physicians with no active collaborative agreement(s), regardless of employment arrangement, that requires the following:1. That on-site physicians may verify a medical task performed by a nonphysician practitioner provided that the verifying physician is present for key portions of any patient care task or procedure verified (similar to the standards for the verification of resident physician care).2. That on-site physicians may only attest, through signature or other written documentation, to tasks, procedures, and elements of patient care that they have verified.3. That the attestation of tasks, procedures, and patient care notes for patients whom the physician has not seen and a request from the employer that a physician attest to care that the physician has not participated in may constitute a breach of ethics or contract on the part of the employer.4. That, to ensure a safe level of patient care provided by nonphysician practitioners, on-site physicians who formally agree to be available for verification or attestation of medical acts by nonphysician practitioners (1) have adequate time set aside from other professional responsibilities and duties to perform the verification and attestation function as determined by the respective physician’s independent medical judgment and (2) receive adequate compensation to account for the loss of individual productivity and lost revenue due to the verification and attestation functions; and be it furtherRESOLVED: That MSMS seek and support legislation on behalf of physicians with one or more active collaborative agreements, regardless of employment arrangement, requires the following:1. That physicians be allowed to fully participate in the recruitment, selection, hiring, performance evaluation and firing decisions regarding the nonphysician practitioner.2. That, to ensure a safe level of patient care provided by nonphysician practitioners, physicians engaged in collaborative agreement (1) have adequate time set aside from other professional responsibilities and duties to perform the collaborative function as determined by the respective physician’s independent medical judgment and (2) receive adequate compensation to account for the loss of individual productivity and lost revenue due to the collaborative function.

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