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Collaborative agreements for AHPs

Medical Staff Leader Connection, August 2, 2006

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With the evolving roles of many of the allied health disciplines, more allied health practitioners (AHP) are being licensed as indepedent practitioners by the state. As a licensed independent practitioner (LIP), the AHP generally functions as a primary-care practitioner and by state authority has permission to do so in any setting if also permitted to do so by the healthcare entity. 

Consider the disciplines of midwife, nurse practitioner, physician's assistant, massage therapist, and surgical assistant as examples of practitioners that may provide care in a hospital. In some states, the midwife and nurse practitioner (NP) are considered LIPs. Some states, however, require a collaborative agreement between the midwife or NP and the physician. Often, these collaborative agreements allow the midwife or NP to function independently while following guidelines or protocols. In some states, the agreement is more restrictive and is considered a supervising agreement.

Currently, no state considers a physician's assistant (PA) an LIP. Therefore, a supervising physician agreement is required for PA licensing. Surgical assistants are at the opposite end of the independent-versus-dependent practitioner spectrum. Regardless of whether the individual is a registered nurse first assistant or a certified operating room technician, the state does not consider these disciplines to be LIPs. 

As with all of the AHP disciplines, a periodic "pulse check" with state statutes is wise. 

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