If you've ever considered collaborating with a nurse practitioner, you may have wondered what the arrangement actually involves, how much time it requires, and whether it makes sense for you.

The answer depends considerably on the NP, the type of practice, and the state in which they practice.

For many physicians, however, collaborating with NPs can be a relatively flexible way to use their clinical experience, support other healthcare professionals, and create an additional source of income.

The key is finding the right NP and the right collaboration.

When Do NPs Need Collaborating Physicians?

Nurse practitioner practice authority varies by state.

In full-practice states, NPs generally do not need an ongoing physician collaboration once applicable licensing requirements have been met. In other states, however, NPs may be required to maintain a formal relationship with a physician to practice, prescribe medications, or exercise certain aspects of their scope of practice.

That means an experienced NP may be completely capable of running their own practice but still need a collaborating physician because of state regulatory requirements.

The physician's role can vary considerably as well. Depending on the state and practice, collaboration might involve periodic chart review, scheduled meetings, availability for clinical consultation, delegated prescriptive authority, or other responsibilities.

Before agreeing to collaborate, both parties should understand exactly what their state requires.

Collaboration Doesn't Have to Mean Taking On Another Practice

One misconception physicians sometimes have is that collaborating with an NP means assuming responsibility for managing another medical practice.

That generally isn't what independent NPs are looking for.

Many are experienced clinicians who own or operate their own practices. They manage their patients, documentation, scheduling, billing, and day-to-day clinical operations themselves.

What they need from a physician depends on state law and the type of collaboration they are seeking.

Some NPs may want a physician who is readily available for consultation and enjoys discussing cases. Others may need relatively limited involvement beyond what is required by their state.

This is why it's important to understand the individual NP and their practice before agreeing to work together.

You Can Decide Who You Want to Collaborate With

Not every NP or practice will be a good fit for every physician.

And that's okay.

A family medicine physician may be very comfortable collaborating with an NP providing primary care but have little interest in an aesthetics practice. A psychiatrist may prefer collaborating with experienced psychiatric NPs. Another physician may enjoy working with newer NPs who want more clinical consultation.

Physicians may also have preferences regarding patient population, medications prescribed, practice size, communication style, or how involved they want to be.

A good collaboration should work for both people.

You should have the opportunity to learn about an NP and their practice, talk with them, ask questions, and decide whether you are comfortable collaborating before entering into an agreement.

Controlled Substances Can Change the Relationship

If an NP's practice involves controlled substances, make sure you understand what your role would be.

Requirements vary by state.

In some states, physician involvement may be greater for certain controlled substances. Texas is one example. In most outpatient settings, APRNs cannot prescribe Schedule II controlled substances under delegated prescriptive authority, which can mean physician involvement is needed when a patient requires a Schedule II prescription.

This can be particularly relevant when collaborating with psychiatric NPs who treat conditions such as ADHD.

Some physicians are comfortable providing this additional level of involvement. Others prefer collaborations that do not involve Schedule II prescribing.

Either is perfectly reasonable.

What matters is discussing it before agreeing to collaborate.

Because additional prescribing, review, or clinical involvement requires additional physician time and responsibility, physicians may also choose to set different collaboration fees depending on what the arrangement requires.

Collaboration Can Provide Additional Income

Physicians typically charge NPs a monthly or annual collaboration fee.

The appropriate amount varies based on the state, specialty, required physician involvement, number of patients or charts requiring review, prescribing responsibilities, availability expectations, and other factors.

For physicians who have the capacity and interest, collaborating with one or more NPs can therefore provide an additional source of professional income.

But the arrangement should make sense for both parties.

The physician should understand what is expected and set a fee that appropriately reflects their time, involvement, and responsibility. The NP should understand exactly what is included in that fee.

Clear expectations at the beginning make for a much better working relationship later.

You Don't Necessarily Need a Middleman

There are companies that connect NPs with collaborating physicians and then remain involved in the financial relationship, sometimes collecting an ongoing portion of what the NP pays for collaboration.

That model works for some people.

But it isn't the only way to do it.

A physician and NP can also establish a professional relationship directly, determine whether they want to work together, agree upon their own terms and fees, and maintain their collaboration with one another.

That's the idea behind Collab-MD.

How Collab-MD Works for Physicians

Collab-MD was created because I discovered something while looking for a collaborating physician for my own NP practice:

There were physicians interested in collaborating with NPs. And there were NPs trying to find them. We simply didn't have an easy way to find each other.

Collab-MD gives physicians a place to make themselves visible to NPs who are actively looking for collaboration.

Physicians can create a profile describing their background, state licenses, areas of expertise, collaboration preferences, and the types of practices they're interested in working with.

NPs can then decide whom they'd like to contact.

From there, the conversation is between you.

You decide whether you want to work together. You determine the terms of your collaboration. You set your own collaboration fee.

And Collab-MD does not take a percentage of your ongoing collaboration fees.

A Collaboration Should Be a Choice on Both Sides

The goal isn't simply to match any NP who needs a physician with any physician willing to collaborate.

It's to make it easier for the right people to find each other.

Talk about the NP's experience, practice, patient population, prescribing needs, expectations, and what they need from you. Be equally clear about what you're comfortable with and what you expect from the relationship.

If it feels like a good fit, you can move forward.

If it doesn't, you don't.

You find each other. You decide what happens next.