Physician Collaboration Issues

Buppert (2018) note that in New Hampshire, nurse practitioners are independent practitioners.  They do not require physician collaboration.  Peterson (2017) noted that nurse practitioners provide quality, cost-effective care to their patients.  Many states do not have independent practice and require physician collaboration.  Caruso (2017) noted that the shortage of primary care physicians might affect collaboration.  In other states without independent practice, the shortage of physicians in rural areas may contribute to collaboration issues.  If there are no available physicians to collaborate with, then nurse practitioners may not be able to work in the rural areas and communities they desire to work in. Blazek (2013) noted that some physicians disagree with the independent scope of practice of nurse practitioners.

Barrier to Practice

One barrier to independent practice is a power struggle between physicians and nurse practitioners; physicians may not support the independent practice of nurse practitioners and advocate against movements that support independence.  Fortunately, New Hampshire is a state with full practice authority.  During clinical rotations with collaborating physicians and nurse practitioners, I notice that in New Hampshire, nurse practitioners are well respected by their physician peers.  Whereas this state already has full practice authority, there is little that can threaten nurse practitioners’ ability to practice.

New Hampshire Nurse Practitioners Practice Issues

Hamric, Hanson, Tracy, and O’Grady (2014) noted that nurse practitioners are leaders in the nursing field and advocated for nursing practice.  As the board of nursing in each state determines the scope of practice of nurse practitioners, it is important for nurse practitioners to lobby and advocate for independent practice.  Most nurse practitioners are Masters-level nurses who must advocate for themselves and for their patients to be able to practice to their full extent.  Nurse practitioners in New Hampshire have already come together to fight for nurse practitioners to be able to practice to their full ability.


Blazek, N. (2013). Nurse practitioners, physicians disagree on primary care roles. Clinical Advisor. Retrieved from

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

Caruso, A. (2017). Redefining the culture of NP-physician collaboration. Urology Times. Retrieved from

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Leadership. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (266-294). St. Louis, MO: Elsevier Saunders.

Peterson, M. E. (2017). Barriers to practice and the impact on health care: A nurse practitioner focus. Journal of the Advanced Practitioner in Oncology, 8(1), 74–81.