does not require the expensive specialization that characterizes physician education today. Hence, APNs should stress the benefits of their practice, i.e. increased quality and cost-effective patient care; decreased malpractice costs and risks; increased physician corporate profitability; reduced actual contact time that physicians must spend with non-urgent patients; and, increased patient satisfaction (pp. 318-320).
The richness of the APN practice is dependent on public policy, and most regulations are dependent on MD supervision or on written documentation of collaboration. In addition, hospital privileges for APNs are limited, and are contingent on MD collaboration. Thus, in addition to the economic benefits that an APN provides in a collaborative setting, strategies for effective collaboration should include that the APN stress the core competencies he/she possesses.
Clinical competence is the first and foremost basis for effective collaboration among clinicians, followed by interpersonal competenceùthe ability to effectively communicate in a variety of clinical/personal situations; mutual trust; and knowledge of cultural and ethnic diversity (pp. 331-333). In addition, recognizing the interdependence between the collaborators increases the value of the relationship, and enhances the quality of clinical decision-making as well as the quality of patient care.
The flip side of stressing the benefits of collaboration entails the removal of barriers to collaboration, which include sociocultural issues--i.e. stereotyping, professional barriers, and organizational and regulatory, i.e. policy, issues (326-328).
In sum, for collaboration between APNs and physicians to work, all the core competencies of the APN should emphasize patient outcomes, i.e. the provision of the best possible patient care.
Aside from the age-old adage: "Physician, thou shall do no harm", bio-ethics addresses ethical decision-making in context...