Doctors can delegate tasks to physician assistants (PA) and nurse practitioners (NP) but they cannot delegate the liability should these midlevel providers commit medical malpractice. Typically these midlevel providers and their employers are sued because the employer failed to provide adequate supervision or the PA or NP was practicing beyond the scope of their training.
The number of PAs and NPs has increased significantly in recent years and is likely going to continue to increase. Over the past ten years the number of PAs has increased more than 100% to where there are now about 85,000 certified PAs in the United States. The number of NPs has increased by 44,000 since 2003. This increase will have an impact on physicians in terms of liability issues and how they practice day to day.
Due to the imminent doctor shortage and the increased number of people in the United States who will acquire insurance under the affordable Care Act, midlevel providers will be treating more patients and performing services which were previously performed exclusively by physicians. For example, PAs can prescribe in every state but only under the supervision of a doctor.
It has been argued that since NPs and PAs do not have the same training as physicians they can often practice beyond their areas of expertise which can lead to liability for the midlevel provider if they are negligent. Additionally, whenever a PA or NP is sued the supervising physician is sued as well. It has been held that when a PA or NP is an agent of the physician; the physician is vicariously liable for the negligence the PA or NP committed.
There are several ways physicians can limit liability when hiring PAs or NPs. First the physician can verify the midlevel provider’s credentials. The physician should also have written protocols. These would define the role of PAs and NPs making it clear what they are authorized to do. Additionally, the physician should be sure to supervise the PA or NP appropriately. PAs and NPs should also feel comfortable asking the physicians questions about their roles. It is very important that all health care providers be aware of their roles and work to avoid committing medical malpractice.
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