Gilbert provided some specific examples of how APPs can directly contribute to a practice. Once a patient has seen a physician for a problem and the plan of care has been made, the PA or NP can conduct the recheck of that problem under that plan of care as long as a physician is physically present within the office. APPs can also see new patients, perform some procedures, and order workups, among other services (see “What Can APPs Do,” below).
Most practices thinking about hiring an APP must first look to their business plans in order to justify the hiring of an APP. Such a business case provides justification for a proposed business change and typically outlines the allocation of capital and resources required to implement it. APPs improve revenue streams, specifically with regard to evaluation and management visits, postoperative care, and procedures, so hiring an APP usually translates into a cost savings for the practice.
Wendy Stern, MD, an otolaryngologist at Southcoast Physicians Group in North Dartmouth, Mass., spoke specifically about building the business case to hire an APP. “Just over half of us are in private practice,” said Dr. Stern, describing the results of the American Academy of Otolaryngology–Head and Neck Surgery socioeconomic survey. Whether a physician is in private practice or practices in a larger setting, the first questions to ask are: What do I need, and what do I want? The answers to these questions could be improved patient access or improved quality of care. According to Dr. Stern, “Every business plan has to look at quality because that is going to affect the bottom line.”
Many physicians feel challenged to deliver the access and quality that an increasing number of patients now demand. APPs can help the practice meet that challenge because they not only improve access, but they can also improve quality as documented by outcomes and patient satisfaction. APPs can provide more face time for the patient, decrease wait time, and improve the efficiency of clinic flow. They also make it easier for patients to access early follow-up clinics and discharge visits.
The APP workforce grew nearly 35% over the last five years, and this growth is expected to continue. While the number of APPs is growing, so is the demand to hire them. Gilbert said that a good way to identify and recruit a qualified APP is for a physician to invest time as a lecturer or preceptor at a local PA or NP program. APPs can also be found through the American Academy of Physician Assistants job finder or the Society of Physician Assistants in Otorhinolaryngology–Head and Neck Surgery. Both NPs and PAs can also be found at Healthcareers.com.