(a) Physician Collaboration. Many states require that the independent nurse practitioner work in collaboration with a "supervising" physician and often have consultation, referral and/or review requirements that must be observed in the course of practice;

In the State of New York an independent nurse practitioner is required to establish a "collaboration agreement" with a supervising physician prior to beginning the independent practice and outline both the supervising physician and nurse practitioner's obligations and requirements under the collaboration arrangement.

(b) Protocol Text. Many states further require that the independent nurse practitioner identify and adhere to a "protocol text" that specifically reflects the nurse practitioner's practice area and provides provisions for, among other things case, case management, diagnosis and treatment of pathology.

(c) Establishment of a Professional Organization. Unlike other forms of business, most states require that licensed professionals apply for and establish a professional corporation or other professional organization that, in many cases, require review and/or certification by the state's department of education, the department of state or a similar organization.

(d) Partnership Agreement. If you are considering partnering with another nurse practitioner - or, in certain circumstances, another licensed individual - it is imperative that the terms, obligations and conditions of the partnership be outlined in a "professional partnership agreement" wherein, among other things, terms concerning the practitioner-partners distributions, management, service obligations and requirements, separation and partnership dissolution are clearly outlined and addressed.

(e) Lease of Practice Location. If you will be leasing the practice's location, issues concerning personal liability, guarantees, indemnification, the practice's layout and structure, and default provisions will likely be raised. Moreover, these issues become greatly elevated when the independent practice involves a partnership.

(f) Compliance Programs. Every health care practice - including independent nurse practitioner practices - is subject to a multitude of federal and state specific statutes and regulations that govern and regulate the practice of medicine. Implementing a comprehensive compliance program that is tailored to the independent nurse practitioner practice's specific needs is critical to ensuring compliance with governing statues and regulations and effectuating the independent practice's due diligence.