Should a Written Collaborative Practice Agreement with a Physician Be Required for Nurse Practitioner Practice?

Abstract

[...]collaborative agreements provide a way to formalize, clarify, and put in writing the roles and responsibilities of APNs and physicians as related to practice situations. Problems that have arisen with the collaborative agreement in Maryland include lag time of several months before being able to start practice or change job locations, inability to volunteer or take a temporary job because there is not enough lead time or physician association with the service, difficulty finding a physician in a specialty in some shortage areas to sign the agreement, necessity of paying a physician to sign on as collaborator, and treatment as "ghost providers" because there is confusion about who is the primary care provider.