Thursday, September 10, 2015

Who supervises the work of an Acupuncturist?

keywords:  supervision, hospital employment, credentialing and privileging, LIP, Joint Commission, the Hospital Sponsor

Supervision of an L.Ac.  
related topics include:

  • the Hospital Sponsor
  • working as part of a team
  • referring to appropriate providers, red flags, etc.


In hospital practice, the following question, “Who supervises the work of an L.Ac. at our hospital/medical center?” is common.  Here is a good answer and some talking points.


Direct Answer

The supervision of an L.Ac. is limited to administrative review.  Practice review (TCM practice review) can only be done by another L.Ac.  L.Ac.s, therefore, as independent practitioners (LIPs), must participate in the Peer Record Review process.  [Quality Assurance review aka Peer Record Review and the assessment of any scope of practice can only be determined by a supervisor and/or senior clinician with the same license and training (master’s or doctorate degree from ACAOM accredited program and current NCCAOM diplomate status).]


Special case:  L.Ac. Internship or preceptorship:  The supervision of an L.Ac.’s clinical work can be done by another L.Ac. as may be the case during an internship or preceptorship.


L.Ac.s are independently practicing providers.  They should be credentialed as professional health care providers, eligible for a “delineation of clinical privileges”.   L.Ac.s are not primary care providers as primary care physicians or advanced registered nurse practitioners are.  L.Ac.s are independent practitioners similar to clinical psychologists, physical therapists, pharmacists, and chiropractors. The Joint Commission uses the term "licensed independent practitioner" (LIP) for this class of provider.


Why Peer Record Review vs. practice supervision

Simple answer:  L.Ac.s are independent practitioners, not technicians.  Hence, they participate, as other credentialed and privileged professional health care practitioners do, in the peer record review process as well as other professional practice evaluation processes (FPPE, OPPE).


Review:

Independently practicing providers vs. technicians

Independently practicing providers/Licensed Independent Practitioners (LIPs)
Technicians
Joint Commission recommends these types of providers be credentialed.
Can be credentialed.  Are NOT privileged.
Has an NPI. 
Carry out the treatment plan their supervisor, the provider, creates
Able to practice with only administrative supervision
Cannot sign notes. 
Has training and education to evaluate a patient
Does not take full responsibility for treatment
Can create a treatment plan
Has a direct supervisor
Can modify a treatment plan
Work is directly or indirectly supervised
Can re-evaluate patient
Does not have ability or authority to evaluate patient
Can adapt treatment procedures
Does not have ability or authority to change or modify treatment or procedure
Does not have ability or authority to modify treatment plan
Does not bill insurance.  Does not have an NPI.

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