If you’re a nurse practitioner or physician assistant who needs a supervising or collaborating physician, your options come down to three main paths: leveraging your professional network, using online matching platforms, or reaching out directly to physicians in your specialty. The right approach depends on your state’s specific requirements, your practice setting, and whether you need in-person oversight or a remote collaboration arrangement.
Know Your State’s Requirements First
Before you start searching, you need to understand exactly what your state demands from a supervision arrangement. States vary dramatically in what “supervision” means, how many practitioners a single physician can oversee, and how close the physician needs to be to your practice location.
In California and Florida, a physician can supervise no more than four PAs at one time. Texas has no cap on general supervision but limits prescriptive authority delegation to seven PAs or their full-time equivalent. Hawaii is even more restrictive, allowing a supervising physician to oversee only two PAs simultaneously. These caps matter because a physician who’s already at their state limit simply cannot take you on, no matter how willing they are.
States also differ on chart review. Alabama requires supervising physicians to complete quarterly quality assurance reviews with each PA, including a “meaningful sample” of medical records with defined quality outcome measures. Alaska, by contrast, doesn’t require chart review by statute at all, though individual practices may still mandate it. Your state medical board’s website will spell out the exact requirements for your license type and specialty.
Where to Search for a Supervising Physician
Your strongest starting point is your existing professional network. Former attendings, preceptors from clinical rotations, and colleagues from residency or fellowship programs already know your clinical skills. A physician who has watched you work firsthand is far more likely to agree to a supervision arrangement than a stranger reviewing your CV. Reach out to former mentors, attend local medical society meetings, and ask colleagues in your specialty if they know physicians open to collaboration.
Online matching platforms have emerged to fill the gap when personal connections fall short. Physician Collaborators, for example, is a network of board-certified physicians in internal medicine, family medicine, emergency medicine, and psychiatry who specifically partner with NPs and PAs. They promise to match you with a collaborator within a week. Similar platforms exist across specialties, and searching “collaborating physician” or “supervising physician network” along with your state and specialty will surface the options available to you.
Hospital and health system job boards sometimes list positions that come with built-in supervision arrangements, which eliminates the search entirely. If you’re open to employed practice rather than independent work, this is the simplest route. Community health centers and federally qualified health centers are particularly likely to have structured supervision models already in place.
What Supervision Actually Looks Like
Medicare defines three levels of physician supervision, and understanding these helps you communicate clearly with potential supervisors about what the arrangement involves. General supervision means the physician oversees your work but doesn’t need to be physically present while you see patients. They’re responsible for your training, equipment, and overall clinical direction. Direct supervision requires the physician to be present in the office suite and immediately available, though not necessarily in the room with you. Personal supervision, the most intensive level, means the physician must be in the room during procedures.
Most outpatient NP and PA supervision arrangements fall under general supervision, where the physician reviews charts, remains available by phone, and meets with you on a regular schedule. The specific cadence of meetings, chart reviews, and availability expectations should be spelled out before you finalize any agreement.
What a Supervision Agreement Should Include
A formal written agreement is required in most states and advisable everywhere. At minimum, it should cover the scope of your clinical practice, the physician’s responsibility to monitor and oversee that practice, and access to clinical records. Your supervisor needs the same access to patient records that any employee of your practice would have.
Termination clauses protect both parties. A standard arrangement requires 30 days’ notice from either side if someone wants to end the agreement. In many states, you must notify your licensing board within 10 days of the termination date. Critically, you may need to stop practicing within 60 days of termination if you haven’t secured a replacement supervisor and received board approval. Losing your supervising physician without a backup plan can shut down your practice, so building in a transition period and identifying a potential backup collaborator from the start is worth the effort.
The agreement should also clarify how prescriptive authority works in your arrangement, which procedures you can perform independently versus those requiring direct oversight, and how after-hours patient emergencies will be handled.
How Much Supervising Physicians Charge
If you’re in independent practice and contracting with a physician for supervision, expect to pay between $500 and $1,200 per month based on current market rates from matching platforms. The Oklahoma Medical Board established a fair market value of up to $500 per hour for supervision of advanced practice registered nurses, though most arrangements are structured as flat monthly fees rather than hourly billing.
Fees vary based on your specialty (psychiatry and surgical specialties tend to command higher rates), geographic location, patient volume, and the intensity of oversight required. A physician reviewing 20 charts per month in a low-risk primary care practice will charge less than one providing direct supervision for procedural work. Some physicians prefer a percentage of collections rather than a flat fee, particularly in higher-volume practices. Get the compensation structure in writing before you begin, and make sure it complies with your state’s fee regulations if any exist.
Vetting a Potential Supervisor
Before entering any agreement, verify that the physician holds an active, unrestricted license in your state. Every state medical board maintains a license lookup tool. Illinois, for example, offers a searchable database approved as a primary verification source by the Joint Commission and the National Committee for Quality Assurance, with daily updates. Most states offer similar tools. Search for the physician’s name, confirm their license status, and check for any disciplinary history. For disciplinary documents beyond what’s publicly listed, you can submit a freedom of information request to the relevant board.
Beyond license status, confirm that the physician is board-certified in a specialty relevant to your practice, carries active malpractice insurance, and has experience (or at least willingness) in a supervisory role. A brilliant clinician who resents the administrative burden of chart reviews and scheduled meetings will be a poor collaborator. During your initial conversations, ask how they’ve handled supervision in the past, how responsive they are to clinical questions during business hours, and what their expectations are for documentation.
Malpractice Insurance Considerations
If you’re employed, your employer most likely provides malpractice coverage, but don’t assume. Ask for a certificate of insurance annually to confirm you’re listed as a “named insured” on the policy. Being covered under a general employer policy isn’t always the same as being individually named, and the distinction matters if a claim is filed.
If you’re in independent practice with a contracted supervising physician, you’ll typically carry your own malpractice policy. Your supervisor should also confirm that their policy covers supervisory activities. Some malpractice carriers require notification when a physician takes on a formal supervision role, and failure to disclose this can create coverage gaps. Discuss insurance arrangements explicitly during your initial negotiations so neither party discovers a gap after a problem arises.
Making the Arrangement Work Long-Term
The supervision relationships that last are the ones where both parties feel the arrangement is fair, communication is easy, and expectations are clear from day one. Schedule regular check-ins beyond the minimum your state requires. Use those meetings not just for chart review but to discuss challenging cases, clinical questions, and any scope-of-practice concerns that have come up.
Keep a running log of your supervision activities: dates of meetings, charts reviewed, clinical questions discussed, and any changes to your practice protocols. This documentation protects you during audits and license renewals. It also makes the transition smoother if you ever need to switch supervisors, since a new physician can quickly see how your practice operates and what oversight has looked like.