Are APNs Required to Have a Collaborative Agreement With All of the Surgeons Whose Patients They Treat?

Carolyn Buppert, NP, JD


February 24, 2006


As a hospital-employed advanced practice nurse (APN) in Illinois, I see patients of many different physician/surgeons. My collaborative agreement is with the surgeon with whom I work most closely and who performs the majority of surgeries in my patient population. Am I required to have a collaborative agreement with all of the surgeons whose patients I follow/treat?

Response from Carolyn Buppert, NP, JD

To answer a question about collaborative requirements, always start by reading the state law.[1] You are required to meet its requirements, but you have no responsibility to exceed its requirements. In Illinois, a collaborative agreement with a collaborative physician is required for APN practice. The collaborating physician must participate in the joint formulation and joint approval of orders or guidelines with the APN, periodically review such orders, be on site at least once a month, be available through telecommunications for consultation, and, if the APN is going to prescribe, delegate the authority to prescribe. So, only one collaborating physician is needed, and there is no reason to enlist others when one will do.

However, because an APN may perform only those services that the collaborating physician generally provides to his or her patients, and may prescribe and dispense only those medications within the collaborating physician's scope of practice, an APN may want to have more than one collaborating physician, if the APN plans to perform services or prescribe medications that are not within the collaborating physician's scope of practice.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.