The supervising physician for the California nurse practitioner (NP) "Dr Sarah," who illegally presented herself as a doctor, has been fined $25,000. The case highlights the liability concerns doctors face when they oversee NPs.
According to the complaint, ob/gyn Anika Moore, MD, FACOP, agreed to pay the civil penalty but admitted no fault related to allegations of unlawful supervision of Sarah Erny, DNP. Moore did not respond to an emailed request for comment.
Erny was fined nearly $20,000 after an investigation in November by the San Luis Obispo County, California, district attorney found she had committed false advertising and fraud by regularly calling herself "Doctor" on social media and with patients.
A group of California DNPs, including Erny, pushed back against those regulations last year by suing the state, alleging a law restricting the use of the honorific title violates their right to free speech.
For collaborative agreements, California law requires physicians and the NPs they supervise to adhere to specific roles and prescribing privileges as outlined in the written document. Supervising physicians must routinely review the terms of the agreement and the nurse's performance and skills.
Even as more states loosen supervision restrictions for NPs, physicians who still do so face added risks. Medical boards may sanction them for improper supervision, and the majority of patients who sue their NP for malpractice also sue the supervising doctor.
Moore lived in Massachusetts in 2018 when she entered the agreement with Erny, but she only skimmed the document and did no further research on her supervising responsibilities, court records said. Although Moore was not compensated for the oversight role, she said she made herself available over the next 2 years to answer Erny's questions.
However, an investigation by the California Department of Consumer Affairs and the San Luis Obispo County District Attorney's Office found that Moore never reviewed any physical medical records of Erny's patients.
Instead, without Moore's knowledge, Erny opened an independent medical practice near San Luis Obispo, called Holistic Women's Health, where she provided medical services and drug supplements, including prescribing controlled substances like testosterone.
Meanwhile, Moore believed Erny was practicing in a clinical setting with other physicians, court documents said.
Erny and Moore agreed to terminate the collaborative agreement in March 2021.
"As a supervising physician, Moore accepted a professional commitment to collaborate and supervise Erny," Assistant District Attorney Eric Dobroth said in a statement.
"Our office seeks to ensure that every physician that consents to supervise a nurse will comply with California requirements and take great care to routinely evaluate whether the terms of the agreement are being met and to evaluate the nurse's performance to ensure best patient care."
Steph Weber is a Midwest-based freelance journalist specializing in healthcare and law.