Finally, the court looked at public policy and noted that the legislature had created a detailed list of requirements that a collaborative practice agreement must fulfill. The reason, the court noted, is to protect and ensure public safety.

Based on this, the court rejected Dr. J’s argument that he did not owe a duty to the patients of Ms. D with whom he had a collaborative practice agreement, and it ruled that the case could proceed against him. The case was remanded back to the lower court for a jury trial, where the jurors would decide whether Dr. J and Ms. D breached their duty to the patient, and whether the breach caused the patient’s death.

Protecting Yourself

Collaborative practice agreements vary widely across states. Some states do not require collaborative practice agreements at all. In other states, NPs can’t diagnose, treat, or prescribe medication without one. It’s very important to understand the particular laws of your state.

If you do enter into a collaborative agreement with another clinician, it’s essential that both of you understand and follow the requirements. This protects you, the other clinician and the patient. In this case, Dr. J and Ms. D were aware that the physician was required to review a random 5% of Ms. D’s patient charts each week. Yet neither clinician took this seriously. Had Dr. J reviewed the charts as required, he might have spotted a dangerous prescribing behavior and could better protect Ms. D’s patient.

While malpractice for the patient’s death has not yet been established (and may never be), this case is an example of the necessity for both parties to comply with all requirements of a collaborative practice agreement.