Nurse practioner working for DPM

[PADPM]

I was having a discussion with someone regarding nurse practitioners working for a DPM. So I researched the idea and actually found a DPM in Kentucky who not only employs a NP, but she actually sees/treats patients on her own. There are days she is in the office treating podiatric problems with no doc in the building. So I guess that answers that question, at least in Kentucky.

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[PatchAdamsFan]

Is this meant to be a case for or against NP autonomy? Just wondering, I know its a hot topic in the medical forums.

 

[MarquetteGuy]

I am a third-year resident who will be graduating in a few short months. The orthopaedic group I'm joining is adding a NP for me, as this is allowed under my state's laws. A PA however, would not be allowed to work under me in my state. Interestingly, a person with the dual NP/PA degree would still be allowed to work under me.

 

[buBBa15]

I am a third-year resident who will be graduating in a few short months. The orthopaedic group I'm joining is adding a NP for me, as this is allowed under my state's laws. A PA however, would not be allowed to work under me in my state. Interestingly, a person with the dual NP/PA degree would still be allowed to work under me.

Congrats on joining an ortho group. How'd u manage to land that? I understand its rather difficult. Care to give some advice or tips?

 

[PatchAdamsFan]

I don't understand why everyone salivates over the ortho groups. You will essentially be a full ortho surgeon, never become a partner, and not act as a true podiatrist in any way. If ortho groups are your goal, go to med school.

 

[MarquetteGuy]

Sorry, I certainly don't want this thread to get off topic so quickly, but yes, I do become a full partner after my first year. I have the exact same contract as every other MD partner in the group signed initially. But back to the original topic, I was just offering my two cents in regard to working with a NP.

 

[dtrack22]

Yeah, whoever told you that you can't become a full partner (in most states at least) in an ortho group is either lying or misinformed.

Back to the NP. There is at least one practice in town that employs an NP to do wound care for them. From my observations she operates with pretty much complete autonomy. There is a dpm in the building most, if not every day, however. Works out really well there. Including additional income for the group.

 

[buBBa15]

I don't understand why everyone salivates over the ortho groups. You will essentially be a full ortho surgeon, never become a partner, and not act as a true podiatrist in any way. If ortho groups are your goal, go to med school.

I choose to keep ALL of my options open. Only a fool would want to restrict himself.

 

[PADPM]

Is this meant to be a case for or against NP autonomy? Just wondering, I know its a hot topic in the medical forums.

We just looked into this recently, and in addition to hiring at least one more doc this year, we looked into hiring an NP who would help with hospital rounds, consults, certain office procedures, etc. However, whether or not an NP can be employed as an independent practitioner under a DPM varies from state to state. In some states the NP is required to be under the direct supervision of a physician. Some states exclude DPMs from that definition.

 

[All4MyDaughter]

I was having a discussion with someone regarding nurse practitioners working for a DPM. So I researched the idea and actually found a DPM in Kentucky who not only employs a NP, but she actually sees/treats patients on her own. There are days she is in the office treating podiatric problems with no doc in the building. So I guess that answers that question, at least in Kentucky.

NPs have autonomous practice in Ky, at least for diagnosis and treatment. Prescribing requires physician supervision. The NP's prescriptive authority is defined by the scope of practice of the supervising physician. The physician's supervision of the NP does not have to be on-site.

 

[hematosis]

So a NP can prescribe a anticholinergic drug for something like...IBS (perhaps dicyclomine), which is out of a podiatrists scope of practice. However, in some states, this same NP is hired and supervised by a podiatrist to prescribe this medication. Anyone else think this is interesting? I wonder if there is any rule that they must work within the Podiatrists scope of practice.

 

[ldsrmdude]

Looking at A4MDs post, she said that the NPs prescriptive authority is defined by the scope of practice of the supervising physician. I would interpret that to mean that if a DPM is supervising a NP, then the NP could prescribe things within the podiatrists scope of practice. When it comes down to it, a podiatrist can prescribe basically any drug. But being able to do something and it being a good idea to do something are not always the same. Prescribing medications outside your scope of practice is not usually a good idea.

 

[All4MyDaughter]

Looking at A4MDs post, she said that the NPs prescriptive authority is defined by the scope of practice of the supervising physician. I would interpret that to mean that if a DPM is supervising a NP, then the NP could prescribe things within the podiatrists scope of practice. When it comes down to it, a podiatrist can prescribe basically any drug. But being able to do something and it being a good idea to do something are not always the same. Prescribing medications outside your scope of practice is not usually a good idea.

Remember, I'm only talking about Kentucky. But yes, if the DPM is supervising the NP, the NP could only prescribe medications needs to treat conditions of the foot and ankle. So, while I agree that this could be pretty much any drug, there are some classes of medication that might be pushing it. The NP would also need a separate collaborative agreement in order to prescribe controlled substances.

 

[cspmstudent]

A nurse practitioner works at San Francisco general hospital and teaches 2nd and 3rd year CSPM students nail avulsions and some real basic podiatry. She works with a couple podiatrists who I assume supervise her. The podiatrists are also active in teaching at SFGH.