Over the past few decades, the number of nonphysician providers (NPPs) in healthcare settings has grown substantially. NPPs include physician assistants (PAs) and advanced practice nurses (APNs) such as nurse practitioners (NPs), certified nurse midwives (CNMs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs). NPPs fill the gaps where physicians are lacking and offer a cost-efficient solution to improving patient care by increasing the efficiency of physicians. NPPs can also improve patient satisfaction by offering greater access and appointment availability, which can reduce the direct and overhead costs of the practice.
Physicians who utilize NPPs in their practice are required to have written agreements with them. The intent of these agreements is to provide requisite physician oversight, clearly define the scope of practice for the NPPs, and promote communication and coordination between members of the healthcare team.
Many providers are unaware of this critical regulatory requirement, which exposes them to unnecessary risk within their practices.
Which NPPs Are Required to Have a Formal Written Agreement?
- Advanced Practice Nurses: Regulated by the New Jersey Board of Nursing (NJBON), APNs are independent professionals who do not work under the supervision of a physician in the state of New Jersey but those who wish to have prescribing authority or order devices. They must have a joint protocol with a collaborating physician in place.
- Physician Assistants: Regulated by the NJ Board of Medical Examiners (NJBME), PAs are required to engage in practice only under the direct supervision of a physician. PAs must maintain a formal, signed delegation agreement between the supervising physician and physician assistant.
Note: The PA title is undergoing a change to Physician Associate, but the NJBME has not yet changed its use of this title. - Certified Nurse Midwives: Regulated by the Midwifery Committee which falls under the NJBME, CNMs are required to have formal, written consulting agreements with physicians.
Support for Conventus Members
Conventus members can access the full Spotlight on BME Regulation article which has detailed information regarding joint protocols for APNs, PA delegation agreements, and CNM consulting agreements, plus our recommendations. In addition, Conventus members can visit the Conventus Knowledge Center for sample APN Joint Protocol Agreement, PA Delegation Agreement, and CNM Agreement to use as a basis when developing an agreement specific to your practice
As always, Conventus members can also call the Practice Resource Department at (877) 444-0484, ext. 7466 to speak with a member of our team for assistance with understanding or questions regarding your requirements under these regulations.
