Collaborative practice information

Rules, opinions and compliance

  • Many questions may be answered by a careful review of the rules that govern collaborative practices.
  • Also see Board opinions concerning physician extenders.
  • The Board of Medical Examiners and the Medical Association of the State of Alabama present periodic seminars on ensuring quality in the collaborative practice. All current and prospective collaborating physicians are advised to complete this course.
  • A courtesy collaborative practice inspection may be scheduled with one of the Collaborative Practice Nurse Consultants (see Contacts page) 
  • For information about applying for approval of a collaborative practice agreement, see collaborative practice registration application

Forms and Information

Frequently asked questions

Q:  How many nurse practitioners may a physician supervise?

A:  The determination is not made on the number of people. The Board limits a physician to supervising a total of 160 "full time equivalent" (FTE) hours per week of mid-level practitioners.  Mid-level practitioners include CRNPs, CNMs and PAs. The county and state health departments are exempt from this rule.  Please contact our office if you have further questions about this issue.

Q:  How much time is a physician required to spend with a nurse practitioner?

A:  The Collaborating Physician shall have no additional requirement for documentation of on-site collaboration when working in the same facility with the CRNP.
For the CRNP with less than two years (4000 hours) of clinical experience since initial certification or in the collaborating physician’s practice specialty, the physician must be present for not less than ten percent (10%) of the CRNP’s scheduled hours in an approved practice site. 
For the CRNP with two years (4000 hours) of clinical experience, the physician must meet no less than quarterly and must visit remote sites no less than twice annually. 

Q:  Can nurse practitioners prescribe medicines?

A:  The legend and controlled drugs a nurse practitioner is authorized to prescribe are specified in the collaboration agreements and formularies.  To prescribe controlled substances, nurse practitioners must apply and be approved for a Qualified Alabama Controlled Substances Certificate (QACSC).  To prescribe Schedule II controlled substances, a nurse practitioner must also apply and be approved for a Limited Purpose Schedule II Permit (LPSP).  See the Board's web page on controlled substances certificates for more information.  Currently, nurse practitioners may only prescribe certain medications for the treatment of obesity.  See Board Rules, Chapter 540-X-17 for more information regarding prescribing for obesity/weight loss.

Q:  Can a physician with a restricted license collaborate with a nurse practitioner?

A:  No, a collaborating physician's Alabama medical license must be current and unrestricted.

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