Under the new law, nurse practitioners expect that medical staffs will offer privileges without a requirement for supervision. Medical staffs have a responsibility to ensure quality of care and verify every member's competence, even as she or he acquires clinical experience. We believe that a model using progressive tiers of supervision, culminating in a level that allows practice directly accountable to OPPE and peer review, will meet nurse practitioners' expectations and medical staff responsibilities. Medical staff organizations and nurse practitioners have much to offer one another and need to develop processes that allow them to work together for the optimum benefit of their patients. The author wishes to thank Helen Brown, CRNP, for her assistance in the preparation of this article.
