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DALLAS—As changing financial realities force healthcare to intensify its focus on patient satisfaction, streamlined habits, and higher patient volumes, there has never been a better time to consider adding advanced practice providers (APPs) to a medical practice, said members of a panel session at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, which was held in Dallas in September.
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December 2015“We live in an ever-moving target of healthcare,” said panel moderator Kristi Gidley, PA-C, a physician’s assistant, administrative director, and supervisor of advanced practice providers in the department of otolaryngology at the University of Alabama in Birmingham. Under the Affordable Care Act, there are approximately 12 million newly insured people, many of whom have plans with high deductibles. That has created a “climate where the payers and patients are quite sensitive to the value and the cost of medicine,” she said.
APPs, who are physician assistants and nurse practitioners, can improve patient flow through the practice, helping to produce shorter wait times, greater patient satisfaction, higher numbers of patients, and better documentation that can lead to higher reimbursement, panelists said.
Physician assistants are trained as generalists, with approximately 1,000 didactic hours and more than 2,000 clinical hours. A master’s degree is required, and they’re certified by the National Commission on Certification of Physician Assistants and licensed through state medical boards.
Nurse practitioners, who often choose a specialty area, complete approximately 500 didactic hours and 800 clinical hours. A master’s degree is required, as with physician assistants. They are licensed and certified through state medical boards. While some specialty post-graduate fellowships are offered, most practical training is done on the job.
Hiring, training, and supervising APPs is usually worth the investment, panelists said. The tasks that APPs handle cover a wide range, and the degree to which they work independently from physicians depends on their skill and comfort level, as well as the comfort level of the physicians with whom they work. There tends to be a progression to more complex tasks and greater independence over time.
Nuances of Training
Scott Stringer, MD, chair of otolaryngology and communicative sciences at the University of Mississippi in Jackson, advised that it is important to hire an APP carefully. “You need to choose well early,” he said. “It just depends on the person and the background and the experience, but clearly to get someone to a high function can [take] up to two years.”