• HOT TOPIC!!! • HOT TOPIC!!! • HOT TOPIC!!! •

Here are some of the new recommended rules from the AMA regarding APN supervision:

• MD must be in Active (not retired or in an administrative role) practice of Medicine and available for consultation at all times: available was defined as no more than 30 miles or 30 minutes away from the practice site. The MD must also have RECENT experience and or expertise in same area of medicine as APN.

• MD must implement a policy to notify patients before treatment as to the title of the Provider: APN or MD

• MD must post a sign that informs patients of the ability to request their chart be reviewed by MD

• MD must ensure all pts are provided a discharge record which reflects services provided during visit (I stated this was a good recommendation, but asked would this be required of the MD also-no response)

• Supervisory MD is CONTACTED and GIVES CONCURRENCE before: any controlled drug prescription is issued for a supply of more than 5 days to any patient (what about our ADHD and chronic pain patients????) and on ANY NEW or RENEWED controlled drug which is prescribed to the same pt for the same condition.

• MD shall be required to visit any remote site at least once every 30 days for no less than a total of 8 hours/month and while the APN is on site.

• The MD shall be responsible for assuring that the APN places a checkmark beside or a circle around the name of supervising MD on Rx pad. (Pharmacists have notified TMA that this is not being done consistently)

• MD shall be limited to supervising no more than a total of 4 APNs/or PAs who provide services at a remote location at any one time.

The rules are to cover ALL APN roles, not just the role of a NP prescriber as is currently covered.

TNA is gearing up to deal with these issues; Make NO mistake-these rules are already on the AGENDA in JANUARY for the Board of Medicine!   (even though we have not been given the opportunity to collaborate or discuss). The TMA is soliciting their members for "evidence" of inappropriate supervision or patient care by APNs to bolster their case for a change in supervisory rules. Though the proposed rule changes are a response to retail clinic growth, they do not differentiate between APN specialty or practice site. Taking a page from the TMA book, each and every one of you (all 6,000 APNs in Tennessee) will be receiving a letter from TNA asking for feedback from you and your supervising physician(s) re: quality, collaboration and practice issues.  It is imperative that we have documentation to present to the Board of Medical Examiners to support current APN practice. When you receive the letter from TNA, please respond quickly.