If you’re a Psychiatric Mental Health Nurse Practitioner (PMHNP) practicing with a Supervising physician, also known as a Collaborating MD, this article will explain what supervising physicians do at Rula, what they don’t do, and how to handle common questions from pharmacies and patients.
What is a Supervising Physician?
A Supervising physician (SP) is a licensed medical doctor, often a psychiatrist, who provides clinical oversight for a PMHNP. Supervising physicians exist to meet state scope-of-practice requirements and regulatory standards, not to deliver direct patient care.
At Rula, supervising physicians support PMHNPs behind the scenes and are not treating providers.
What Supervising Physicians Can and Cannot Do at Rula
| Supervising Physicians CAN | Supervising Physicians CANNOT |
|---|---|
| Access AMD to review patient charts | Use the Rula Provider Portal |
| Review prescriptions within DrFirst | Prescribe medications (including controlled substances) + treat patients |
| Provide clinical guidance and consultation to PMHNPs | Act as a credentialed Rula provider |
| Review clinical notes in AMD using the “Review” function | Sign or authorized prescriptions + Sign Clinical Notes |
Even if state law allows physician supervision, supervising physicians at Rula do not prescribe or sign on behalf of PMHNPs.
Why Supervising Physicians are Required
Supervising physicians are required due to:
- State scope-of-practice laws
- Controlled substance regulations
- Clinical risk management requirements
- Medical board accountability
They help ensure PMHNP:
- Meets regulatory standards
- Follows evidence-based guidelines
- Has a physician consultation available when required
State Requirements for Supervising Physicians
States Where an SP is Required at All Times
FL, GA, NC, OH, TX, PA, WI, LA, IN, MS, MI, TN, MO, SC, OK, AL
States Where an SP may Be Required
MN, NY, VA, CO, MD, MA, CT, NV, ME, NE, KY, SD, WV, VT, AR
Important: Rula does not determine whether you need a supervising physician in these states. It is your responsibility to determine requirements and notify Rula during onboarding.
If you cannot prescribe controlled substances in your state and need an MD prescriber, Psych Support can help explore rematching the patient with a credentialed MD, if available.
How Supervising Physicians Review “Sign Off” on Notes
At Rula, Supervising Physicians review notes but do not sign them. If state rules require physician review of a percentage of notes:
- Supervising Physician logs into AMD
- Opens the patient chart
- Opens relevant note
- Clicks “Review”
If a Pharmacy Requests Supervising Physician's Name or Address
- It is okay to share Supervising Physician information with pharmacies when requested.
- You are responsible for adding Supervising Physician details to the prescription when required by state law.
- If needed, include Supervising Physician details in the “Additional Notes to pharmacy” field.