Indeed, collaborative agreements between NPs and physicians in New York currently seem to amount to little more than a financial agreement. "Nurse practitioners who do have their own practice pay a practicing physician to collaborate with them," Ferrara says. "Existing laws do not require the physician to be on site."
Not having to be onsite means that collaborating physician aren't necessarily providing any close "supervision" over an NP's practice. Still, the new law received pushback from groups such as the Medical Society of the State of New York.
"Organized medicine was our pushback. They have touted that nurse practitioners need to be under the supervision of a physician, which is not how we practice today," Ferrara says. "It's about control. It's about a whole lot of things. It's about maintaining status quo; it's about subscribing to a model of care that obviously isn't working."
And it's also, at least somewhat, about money.
"It does come down to finances," Ferrara says. "Our basis has been that this collaborative agreement has become sort of a financial transaction that does nothing for quality of care… it really makes no sense to do that."
Although this law makes it possible for NPs who have more than 3,600 hours (which Ferrara says equals about two years of work) to practice without the written collaborative agreement, he's careful to temper the idea that NPs in New York State will be practicing "independently," calling that a "loaded word."