Center for Advanced Practice Nursing and Allied Health

Supervising Physician's Responsibilities

Clinical Supervision
A supervising physician, certified nurse practitioner or a substitute supervising physician must possess a current, unencumbered license to practice in the state of Tennessee.
A supervising physician and/or substitute supervising physician shall have experience and/or expertise in the same area of medicine as the certified nurse practitioner.
Supervision does not require the continuous and constant presence of the supervising physician


The supervising physician must be available for consultation at all times or shall make arrangements for a substitute physician to be available.
The supervising physician shall be responsible for ensuring compliance with the applicable standard of care under. Additionally, the supervising physician shall develop clinical guidelines in collaboration with the certified nurse practitioner to include a method for documenting consultation and referral.

Protocols are mandated by the Tennessee Board of Medical Examiners and are defined as written guidelines for medical management. (Chapter 0880-6-.02, Tennessee Board of Medical Examiners Rules and Regulations) 
  • Shall be jointly developed and approved by the supervising physician and nurse practitioner;
  • Shall outline and cover the applicable standard of care;
  • Shall be reviewed and updated biennially;
  • Shall be maintained at the practice site;
  • Shall account for all protocol drugs by appropriate formulary;
  • Shall be specific to the population seen;
  • Shall be dated and signed; and
  • Copies of protocols and formularies shall be maintained at the practice site and shall be made available upon request for inspection by the respective boards.

Quality Review
A supervising physician shall personally review at least twenty percent (20%) of charts monitored or written by the certified nurse practitioner every thirty (30) days.

Once every ten (10) business days the supervising physician shall make a personal review of the historical, physical and therapeutic data and shall so certify by signature on any patient within thirty (30) days:
  • When medically indicated;
  • When requested by the patient;
  • When prescriptions written by the certified nurse practitioner fall outside the protocols;
  • When a controlled drug has been prescribed.

The supervising physician actively participates in the initial and continued competency validation process including but not limited to:
  • Annual competency evaluations;
  • Special privileges, (advanced procedures)


This page was last updated May 23, 2012 and is maintained by