There was a time when people who were sick or pregnant would go to the doctor's office and be examined and treated by a physician. As the practice of medicine and the provision of health care continue to evolve, it has become increasingly common that diagnosis, care and treatment are provided not by physicians but by other health-care professionals, such as nurse practitioners and midwives.

The reasons for the proliferation of health care administered by non-physicians likely include efforts to control costs, limitations of resources and the greater degree of specialization that continues to develop within fields of medicine. However, these non-physician health-care providers are not permitted to practice with total independence, as if they were doctors. To the contrary, the statutes that permit these non-physicians to care for patients expressly require collaboration with physicians. This column explores the liability of physicians when, in the course of this collaboration, they fail to provide proper supervision or oversight.

Statutory Schemes

Before turning to the decisional law, it is important to examine the statutory schemes governing nurse practitioners and midwives, which are set forth, respectively, in Education Law §6902 and §6951. Pursuant to the former, the practice of certified nurse practitioners “may include the diagnosis of illness and physical conditions and the performance of therapeutic and corrective measures within a specialty area of practice, in collaboration with a licensed physician qualified to collaborate in the specialty involved, provided such services are performed in accordance with a written practice agreement and written practice protocols” (Educ. L. §6902[3](a)(i)).