What Is a Collaborating Physician, and Do I Really Need One?
Author: Dr. Jay Motley, MD
Let’s start with a true story. A nurse practitioner in Georgia—sharp, seasoned, well-loved by her patients—calls me after getting a scary letter from the state board. Turns out, her collaborating physician hadn’t reviewed a single chart in six months. No meetings. No oversight. Just a signature on a template she downloaded online. That oversight? It cost her in fines and months of disruption.
Not because she wasn’t providing great care.
Because the collaboration was just a paper trail.
The difference between having a collaborator... and having a collaborating physician.
So what is a collaborating physician?
Think of a collaborating physician as the legally required co-signer for your clinical autonomy—the senior provider whose license provides the cover for yours in certain states. It’s a role defined by regulation, but in practice, it’s all about relationships, clarity, and mutual respect.
Depending on the state, collaboration can mean:
Signing a formal practice agreement
Reviewing a sample of your charts every month
Being available for consults (not in person, just reachable)
Signing off on prescribing authority or protocol changes
In some states (like Georgia, Florida, and South Carolina), that agreement has to outline specific responsibilities. Others are more hands-off, but the expectation is still there: if you’re practicing under another license, they need to be actively involved—at least enough to prove it on paper.
The common myths
"It’s just a formality."
This is how people get burned. It is regulatory—but it isn’t a rubber stamp. When an audit hits, the first thing they look for is documentation of real supervision. That means chart reviews, meeting logs, and proof that your MD was more than a signature.
"Any doctor can do it."
Not exactly. Some states restrict what type of physician can supervise based on specialty or distance. Some require them to hold an active license in the same state. And not every MD is cut out for it—some don’t understand NP scope of practice, or worse, want to micromanage.
"My collaborating doc doesn’t actually do anything."
That might be true—for now. Until you get a complaint. Until someone pulls a chart. Until a credentialing committee asks for a copy of your practice agreement and it’s... blank.
The contract pitfalls
We’ve reviewed hundreds of these agreements. The most common problems? Ambiguity, overreach, and boilerplate copy-paste jobs that ignore state laws.
We’ve seen:
Contracts that give the physician a percentage of revenue without any scope defined
Agreements that don’t specify meeting frequency, communication protocol, or chart review process
Supervisory terms that don’t match the state’s actual rules
These aren’t just technical issues. They’re red flags for regulators.
So... do you need one?
If you live in a full-practice authority state: no. You’re free to practice independently.
If you live in a restricted or reduced-practice state: yes. Not maybe. Not sort of. Yes.
And not just a name on paper. You need someone who understands what collaboration looks like—legally, clinically, and practically.
What to look for
You want someone who:
Practices in your state
Respects APPs and sees you as a partner
Has a clear understanding of what supervision means (and what it doesn’t)
Isn’t trying to take a cut of your business without delivering support
We screen for all of that. We match NPs and PAs with doctors who want to support your growth, not slow it down. We don’t believe in paper relationships. We build real ones—with clear expectations, smart contracts, and compliance baked in.
Closing thought
If you’re in a state that requires a collaborating physician, treat that role like you would any key hire. Because that’s what it is.
They don’t run your clinic. But they can derail it if the relationship is wrong.
If you need help finding the right MD—and making sure the agreement holds up under scrutiny—we’re here.
Let’s get it done right.
— Jay