The American Academy of Physician Assistants and the American Academy of Otolaryngology–Head and Neck Surgery will co-sponsor a live CME program for physician assistants that will roll out in 2011, said Jose C. Mercado, MMS, PA-C, president of the Society of Physician Assistants in Otorhinolaryngology–Head and Neck Surgery.
The result of adding a PA to his practice has been a 10 to 15 percent increase in patient visits in the year they have been working together, “and we haven’t peaked yet,” he said. “It’s been a very good experience.”
Paradigms in the Academic Setting
Andrew H. Murr, MD, FACS, vice chair of otolaryngology–head and neck surgery at the University of California, San Francisco (UCSF), works with an NP and a PA in two disparate practice settings. Each morning, the practice NP, Christina Herrera, screens e-mails from primary care providers (PCPs) who are part of San Francisco General Hospital’s Community Health Network serving the city of San Francisco. Working with a computerized referral algorithm that incorporates diagnostic and treatment strategies, Herrera communicates with referring physicians to ensure that patients obtain appropriate pre-consult workups before clinic visits. With test results in hand, patients can then be seen by the otolaryngologist during one of four half-day clinics staffed by faculty members, residents and Herrera. This streamlined process cuts down on repetitive visits, improves patient access and fosters better communication between PCPs and the specialist. Ms. Herrera is trained to perform both flexible and rigid endoscopy and is privileged to do laceration closure. Her value to the department is augmented by the continuity she provides on follow-up for indigent cancer patients and by her involvement with the hospital’s cancer committee.
In the practice setting at the University Hospital, PA Laura Kirk sees patients in tandem with a faculty member. After three months of training, she was incorporated into the office workflow. In addition to her patient care duties, she functions as liaison with the other NPs and PAs in the UCSF system.
Dr. Murr sees the incorporation of NPs and PAs as a boon to the academic otolaryngology practice. Mid-level providers allow for more seamless and streamlined patient care, he said, especially as faculty feel the pressures of the ACGME’s 80-hour workweek.
“At the end of the day, I don’t think that we’re making a large profit with our PA at the university setting, but we’re not losing money, either,” he said. “What we’ve done, at a neutral cost, is to raise the quality of life for our faculty. Their day is better, smoother—and they’re seeing more of the patients that they want to see.”