A Delicate Balancing Act: The Supervision of Nurse Practitioners by Physicians


This post, written by Alex Scarbrough Fisher, was originally published on midlevelu.com, and can be found here. It is republished with the permission of MidlevelU.com. The supervision of nurse practitioners by physicians, in states that require such supervision, is often a delicate balancing act between responsibility on both the supervising MD and the NP. In order to fully illustrate this delicate balance, I will look at the specific requirements for  nurse practitioners and physicians in Tennessee. If you live in a state that requires you as a nurse practitioner to have a supervising physician, I highly recommend reviewing the rules that govern you, as well as the rules and regulations that govern your supervising physician. Understanding what is required of each party will lead to clarity for both individuals, and hopefully a more enjoyable work environment, as well as a safer environment for your patients. Requirements of Nurse Practitioners In […]

Continue Reading

Regulation of Nurse Practitioners


Attorney Alex Fisher recently had another opportunity to sit down with Erin Tolbert, the creator of MidlevelU, an online resource for health care providers such as nurse practitioners and physician assistants, and discuss how nurse practitioners are regulated as a profession. The original article and video, published on MidlevelU, can be found here. Erin and Alex discuss: Who is in Charge of Nurse Practitioners? In some states nurse practitioners are regulated by the Board of Medical Examiners, while in other states nurse practitioners are regulated by the Board of Nursing. The American Association of Nurse Practitioners has a helpful breakdown of the regulation of nurse practitioners in each state that can be found here. How Does the Way You are Regulated Affect Your Practice? In theory, the Board that regulates you should not matter if the regulations are fairly consistent from state to state, but in reality, the Board that regulates a nurse […]

Continue Reading

The Nurse Practitioner Disciplinary Process: How It Works


Attorney Alex Fisher recently had an opportunity to sit down with Erin Tolbert, the creator of MidlevelU, an online resource for health care providers such as nurse practitioners and physician assistants, and discuss how the nurse practitioner disciplinary process works in Tennessee. The original article and video, published on MidlevelU can be found here. Erin and Alex discuss: The Difference Between Disciplinary Action and Medical Malpractice Medical malpractice occurs when a health care provider is sued by an individual, usually a patient or family member of a patient, in civil court. In such a case, the health care provider is being sued for money. By contract, disciplinary action is initiated by the Department of Health, typically once a complaint has been filed against a health care provider, regarding that provider’s professionalism. In such a case, what is at stake is the health care provider’s professional licensure. What happens when a complaint is […]

Continue Reading

Avoiding Disciplinary Action as a Nurse Practitioner


Attorney Alex Fisher recently had the fantastic opportunity to sit down with Erin Tolbert, the creator of MidlevelU, an online resource for midlevel providers such as nurse practitioners and physician assistants, and discuss common pitfalls for nurse practitioners that may lead to licensure discipline. The original article and video, published on MidlevelU can be found here. Erin and Alex discuss: The main reasons nurse practitioners are usually brought before the Board of Nursing, which include prescribing without documentation, ethical concerns, and criminal convictions. Attorney Alex Fisher explains how investigation by the Department of Health in Tennessee is a complaint driven process, which means complaints are initiated by members of the public, such as patients, co-workers, supervisors or employers, and general members of the public. Prescribing Without Documentation Prescribing issues that result in discipline generally concern prescribing narcotics without documenting the rational for prescribing and documenting that the individual is the nurse practitioner’s patient. […]

Continue Reading

Licensing, Regulations, and Hearings Before the DEA


Alex Fisher was contacted by the Albany Law Review to provide a review of the article published in their 78th volume, “Drug Diversion, Administrative Revocation, and Application hearing for Medical and Pharmacy Practitioners: A Primer for Navigating Murky, Drug-Infested Waters.” This article, written by Drug Enforcement Administration (“DEA”) Chief Administrative Law Judge John Mulrooney and DEA law clerk, Andrew Hull, which can be found here, and provides an excellent summary of the administrative process surrounding DEA licenses. Basis for DEA Discipline After receiving discipline at the state level on their medical, nurse practitioner, or physician assistant license, many of my clients are often contacted by the DEA regarding agreed-to restrictions on their DEA license, or even the agreed surrender of that license. The DEA has the authority to suspend, revoke, or otherwise sanction a healthcare provider’s DEA license on the following five bases: material falsification in registration application conviction relating […]

Continue Reading