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Collaborating physician help


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So, I am co-owner with another PA of a practice in WA State.  We have had a fair amount of success, and are expanding.  However, I am running into an issue, and was hoping to get some perspective.

Our current collaborating physician is retiring from practice altogether.  He asked us to find a replacement, and gave us 6 months to do so.  We found a collaborating physician in another state who has worked with one of our new PAs before.  She and him had a good working relationship, and so she introduced us.  After talking everything over, the physician agreed to be our collaborating physician.  The position is solely oversight (quarterly chart review and QI).  He states that he has served in this capacity for an urgent care in the past.  He will have no clinical role at all (this was offered though he declined).  

We wrote up a contract and he signed it.  We paid for his licenses in two states (WA and ID, he lives in NM).  We paid for his malpractice insurance even though he will not be seeing patients.  He was fully aware of the expectations of his position (10% of charts reviewed and co-signed as well as state based required paperwork).  

As it so happens, here in WA State, the law just changed, so no collaborating/supervisory agreement needs approval from the state.  However, they prefer to have it on file and have an online portal to post it, though again, the state doesn't approve it, they just accept the agreement between the physician and PAs.

Anyways, the physician is now expressing confusion and states that he "only signed on to do chart review and QI and to give advice when needed, not supervision".  The state laws allow the collaborating agreement to be whatever the MD/PA duo agrees upon, and that is what we agreed to: is just chart review and QI.  His "supervision" is reviewing our charts and giving appropriate clinical feedback to veteran PAs.  

We are not using his license or NPI for billing purposes at all.  It is all under the group and individual NPIs.

Nothing has changed with our practice agreement, so I don't understand his confusion.  He has threatened to back out after we paid for the expenses of his state licenses and malpractice.  I guess I am writing all this because I am confused about his confusion.  I dont know how to explain to him that in the state of WA, the term "supervision" is what we at the practice decide on, and we decided on it and signed a contract stating as much.

Obviously I am frustrated because if he backs out, we have wasted months with this physician, and we will have to put our practice on hold (except for the one NP we employ) until we find his replacement, and will need to start all over.  How do I reassure him that nothing has changed, and that all we are asking for is chart review as previously discussed?

 

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  • 2 weeks later...
  • Administrator

So, WAPA tried to get supervision changed to collaboration last time (2019) and it was a sticking point, so they let it go in order to get all the other good things.

The RCWs said supervision both before and after the 2019 legislative changes went into effect on July 1, 2021.  The wording hasn't changed. The expectations haven't changed.  The wording? Yeah, that sucks.

PM me if it would help, I can have him talk to the SP I hired through collaboratingdocs.com.

I presume you guys are either in Spokane or Pullman?

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Hi sorry I don’t have much expertise to share but wandering if you would mind sharing which malpractice company you use? Starting a PA owned practice and looking for a company that’s reputable and also insures PA owned practices. I came across CM&F on AAPA but curious if there are others to compare 

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On 9/30/2021 at 10:30 PM, monae622 said:

Hi sorry I don’t have much expertise to share but wandering if you would mind sharing which malpractice company you use? Starting a PA owned practice and looking for a company that’s reputable and also insures PA owned practices. I came across CM&F on AAPA but curious if there are others to compare 

CM&F pays extra money so other companies can't advertise in JAAPA.

Mercer/Proliability is substantially cheaper and were very easy to work with.

Thanks,

Jonathan

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