Do I need to co-sign a nurse practitioner's (NP) note if it states 'discussed with me'?

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Last updated: June 6, 2025View editorial policy

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From the Research

Yes, you should co-sign a nurse practitioner's note if it states "discussed with me." This indicates that the NP consulted with you about the patient's care, and your signature confirms that this consultation occurred and that you agree with or at least acknowledge the documented plan. Co-signing validates the collaborative relationship between physicians and NPs, which is often required by institutional policies and sometimes by state regulations governing NP practice.

The specific requirements for co-signing may vary based on your practice setting, state laws regarding NP scope of practice, and whether the NP has full, reduced, or restricted practice authority. Some electronic health record systems automatically flag notes containing phrases like "discussed with" for physician review and signature. Failing to co-sign these notes could create legal and professional liability issues, as it might suggest that documented supervision or collaboration didn't actually occur.

It's advisable to establish clear protocols with NPs regarding which situations require discussion and documentation to ensure appropriate oversight while maintaining efficient workflow. None of the provided studies 1, 2, 3, 4, 5 directly address the question of co-signing NP notes, but the principle of confirming collaboration and supervision is crucial for maintaining high standards of patient care and professional accountability.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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