APP privileging: Clarifying what they can do, collaborative practice agreements, and switching specialties

The number of advanced practice professionals (APP) applying for hospital and ambulatory privileges is rising rapidly as physician shortages grow. However, regulations and internal standards governing APPs’ work remain variable. Some states grant advanced practice registered nurses full practice authority, while others permit narrower scopes of service and require a physician to provide oversight through a collaborative or supervisory agreement. The vast majority of states require physician assistants (PA) to work under such arrangements. To complicate matters, healthcare institutions may impose stricter practice parameters than those levied by their state.

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