Guidance on Entering Into Agreements With Psychiatric Nurse Practitioners

This article first appeared in Psychiatric News. Cheryl D. Wills , M.D. Published Online: 13 Sep 2023

Because of the shortage of psychiatrists in this country, an increasing number of psychiatrists are interested in entering into collaboration agreements with nurse practitioners or are already working with them. Here are some points to consider.

While physicians are familiar with patient safety standards, quality of care, and accountability for their profession, they may be confused about the standards for nurse practitioners. This is, in part, due to obfuscating messages that physicians receive about nurse practitioners.

Nurse practitioners say that they provide services that are equivalent to those provided by physicians. Some also say that nurse practitioners are different from physicians and that physicians should not be permitted to conduct peer review about the care they provide. In psychiatry, these contentions are mutually exclusive, because there is one standard of care for psychiatric practice. Since many psychiatrists work or will work with psychiatric nurse practitioners, they should be cognizant of their scope of practice and, when appropriate, the nuts and bolts of a collaboration agreement. This article will briefly examine the duties of nurse practitioners in Canada before focusing on collaboration agreements with them in the United States.