Can Podiatrists Supervise Nurse Practitioners?

Like it or not, in many states nurse practitioners are required to be “supervised by” or “collaborate with” a physician in order to practice, prescribe, or both. These laws can be straightforward or complex depending on the state and outline multiple conditions within this so-called collaborative agreement.

Some states, for example, may require that a physician sign a specified percentage of a nurse practitioner’s medical charts. Other states mandate that a physician practice on site with the nurse practitioner a certain number of days or hours each week or month. To remain in good standing and maintain a license to practice, NPs must comply with these guidelines.

State laws typically use the word ‘physician’ in describing the individual responsible for supervising the nurse practitioner. The word ‘physician’, however is somewhat ambiguous and leaves room for legal interpretation. Most states further outline what constitutes a physician by law. In some states, ‘physician’ refers only to a Doctor or Medicine (MD). Other states give similar or equivalent privileges to Doctors of Osteopathy (DO). Podiatrists fall into yet another category.

Podiatrists are Doctors of Podiatric Medicine (DPM). Their educational path is similar to that of an MD including a four-year podiatric medical school followed by a surgical based residency specializing in the foot and ankle.

Like MDs and DOs, in many states, podiatrists are permitted to collaborate with nurse practitioners. For example, in Oklahoma a supervisory agreement with a physician may be fulfilled by “a medical doctor, an osteopathic physician, or a podiatric physician”. The state of Ohio also allows nurse practitioners to “enter into a standard care agreement with a podiatrist or physician”. So, in many states nurse practitioners can in fact be supervised by or collaborate with a podiatrist. Typically, this information can be found in a state’s nurse practice act

Like MDs and DOs, podiatrists have divided opinions when it comes to using nurse practitioners in their practices. Some see NPs as competition to be stamped out. Others are taking advantage of the low overhead and potential for practice growth associated with hiring a nurse practitioner using NPs as a key strategy in expanding their practices. As podiatrists become increasingly aware of the advantages of working with nurse practitioners in states that allow such collaborative agreements, NPs can expect to see growth in the foot and ankle job market.

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