An Assessment of Physician Supervision of Nurse Practitioners

In 21 states, nurse practitioners (NPs) have full practice authority; they are licensed to practice and prescribe without physician oversight. The other 29 states require some level of physician supervision. The authors used an anonymous, online survey to determine the patterns of physician supervision of NPs in Florida and the relationships between physician supervision, practice setting, and NP characteristics. Physician supervision was measured by three factors: the percentage of time the physician is on site, the percentage of medical records reviewed, and the percentage of patients requiring consultations. The relationships among these factors and NP characteristics (sex, race, education, experience) and practice setting were examined. NPs with more experience and those with doctorate degrees worked without a physician on site more often, had fewer patient records reviewed, and were required to consult on fewer patients than those with less experience or without a doctorate. However, some NPs with no experience had no physician oversight, whereas some NPs with more than 20 years of experience had extensive oversight. Males were more likely to practice without a physician on site and had fewer records reviewed.