Committee denies distant collaboration request for hormone‑therapy clinic; cites training, distance and emergency coverage concerns

Dr. Josh Griffin and Dr. Clifton Scott appeared by Zoom to request approval to collaborate with nurse practitioner Miss Davis to provide hormone‑therapy services (including subcutaneous hormone‑pellet insertion) at a clinic in Madison County that the physicians said lacked close local oversight.

The physicians, who said they operate clinics in Oxford and Starkville and supervise several nurse practitioners, described a training and proctoring plan that would bring the nurse practitioner to their offices for multi‑day, hands‑on observation and then have the physicians proctor the first 10 procedures at the local site. Dr. Griffin said the team uses subcutaneous pellets and that ‘‘we've really found really good results using the subcutaneous pellets’’ and that they provide local oversight for providers who practice under their supervision.

Committee members raised concerns about the proposal’s distance from supervising physicians (discussed as roughly 140–200 miles), whether the arrangement would comply with the board’s rule that limits extended remote supervision, and how urgent complications would be handled if they arose from an office procedure. One member noted pellet insertion is “at least considered a minor surgical procedure” and asked how the distant collaborators would assist in the event of uncontrolled bleeding or other complications.

Dr. Griffin said significant post‑procedure bleeding is rare in his five years of experience with pellets and emphasized the importance of training and local protocols for managing expected complications. He suggested local surgeons could serve as further back‑up for emergency events and said the proposed collaborative model includes phone‑access oversight and on‑site proctoring for the first procedures.

Miss Davis, who identified herself as a recently graduated family nurse practitioner with prior experience in critical care and surgery, told the committee she has sought in‑area collaborators and had contacted regional physicians, including an urogynecologist, but had not found a local physician willing to take on the specific supervision she sought. She said she has not yet completed hands‑on training under Drs. Griffin and Scott but had done the online portion and expects to do the clinic visits and proctoring described by the doctors.

After closing the meeting for an executive session, the committee returned to announce its decision to deny the request. The committee cited concerns about adherence to board rules on out‑of‑area collaboration, the proposed supervisory distance for an office procedure, and the lack of closer local backup for urgent complications.

The committee directed questions about the decision to the executive director’s office and recorded that the matter had been denied in executive session.