What are the requirements of a physician to collaborate with a California NP?

In California, the requirements of a physician to collaborate with an NP include collaborating on the development and approving the NP’s Standardized Procedures/Protocols, being available by telephonic contact during patient examinations, and supervising no more than four NPs at one time; the physician’s physical presence is not required¹. Standardized Procedures must be written, signed by authorized personnel, specify NP functions and scope of supervision, include methods for competence evaluation, maintain records of authorized personnel, and provide a method for periodic review².

For prescribing, the collaborating physician may determine the extent of supervision; drugs and devices may be furnished or ordered only under Standardized Procedures or Protocols developed by the NP and the supervising physician and approved by the physician, and those documents must specify the drugs, circumstances, extent of physician supervision, and periodic review of NP competence¹. When Schedule II controlled substances are furnished or ordered, a patient-specific protocol must be authorized by the treating or supervising physician, and a copy of the Standardized Procedure must be presented to the pharmacist upon request¹. Standardized Procedures may also be implemented through collaboration among physicians and NPs for tasks such as ordering durable medical equipment and approving home health plans after physician consultation³.

Under AB 890, some NPs practice without Standardized Procedures: a 103 NP may do so only in a group setting that includes at least one physician⁴. A 104 NP may practice outside a group but must consult and collaborate with other providers and obtain physician consultation in specified situations⁵.