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

To collaborate with a North Carolina NP, a physician must be a North Carolina–licensed supervising physician who provides ongoing supervision, collaboration, consultation, and evaluation of the NP’s medical acts as defined in a signed collaborative practice agreement (CPA) maintained at the physician’s practice site¹². The physician must be continuously available to the NP via direct communication or telecommunication, and North Carolina law does not set a maximum number of NPs a physician may supervise; the Medical Board expects supervision to be appropriate based on practice-specific factors³⁴.

Supervising physicians must provide prescriptive oversight: written instructions for the NP’s ordering of medications, tests, and treatments in facilities, and for prescribing, written indications and contraindications and a policy for periodic physician review of drugs prescribed⁵⁶. Any NP prescription or order is deemed authorized by—and the responsibility of—the supervising physician, and if controlled substances are prescribed, the supervising physician(s) must possess the same or greater controlled substance schedules as the NP as established in the CPA⁷⁸.

Physicians must participate in required meetings and quality processes: monthly meetings with the NP for the first six months and at least semiannual quality improvement meetings thereafter, with documentation that identifies clinical issues discussed and actions taken, signed and dated by attendees, available for Board review for the previous five years, and retained by both the NP and the primary supervising physician⁹¹⁰. The CPA must be reviewed at least annually with a dated signature sheet available for inspection, and any back-up supervising physician must be NC-licensed, a party to the CPA, maintain a copy at their site, and provide supervision when the primary supervising physician is unavailable¹¹¹².