10 Tips for Supervising Non-Physician Clinicians

Many family physicians will supervise a non-physician clinician (NPC) during their career. You may be more familiar with the terms non-physician practitioner, midlevel provider, or advanced practice provider, all of which are used interchangeably. These terms most commonly refer to nurse practitioners and physician assistants.

Although physician supervision of NPCs has become commonplace, many family physicians are not trained in how to do this effectively. Physicians should understand the requirements of supervision to optimize the relationship and to prevent poor patient outcomes, malpractice claims, and medical board actions. The physician is ultimately responsible for ensuring that each patient receives quality care and may be held accountable if they fail to provide adequate oversight or if an NPC under their supervision makes errors.¹

This article offers 10 tips to help family physicians improve their supervision of NPCs.

Most nurse practitioner programs require applicants to have a Bachelor of Science in nursing. The programs then require approximately 500 didactic hours (focused on disease prevention and health education as well as assessment, diagnosis, and treatment) and 500 clinical hours of training.² Master's and doctoral degree programs are available. Doctoral programs typically have an administrative focus, so DNPs should receive similar supervision as other nurse practitioners.

Most physician assistant programs require prior health care experience, but requirements vary. The programs then require approximately 1,000 didactic hours (focused on medical science and behavioral and mental health, along with critical thinking and decision making) and 2,000 clinical hours of training.² The programs offer a master's degree.

Both physician assistants and nurse practitioners must pass a national certification exam before being licensed to practice. Physician assistants must take the Physician Assistant National Certifying Examination (PANCE), while nurse practitioners may choose between the American Nurses Credentialing Center (ANCC) exam or the American Association of Nurse Practitioners (AANP) exam. Nurse practitioners and physician assistants must earn continuing education credits and recertify every 10 years (for physician assistants) or every five years (for nurse practitioners).