What’s the Best Way to Use Outpatient Physician Extenders?

Are physician extenders a valuable asset to an outpatient otolaryngology practice?

Background: Use of physician extenders, nurse practitioners and physician assistants is increasing in specialty and subspecialty medicine. The field of otolaryngology, however, is currently underrepresented.

Study design: Contemporary review.

Setting: Department of Otolaryngology and Communicative Sciences, University of Mississippi, Jackson.

Synopsis: The authors proposed a framework of five practice models for the integration of advanced practice providers (physician extenders) into an otolaryngology practice. Scribe, the most basic model, occurs when the physician extender shadows the physician and completes clerical tasks and possibly personnel hires. In a Collaborative Practice, an advanced practice provider serves as a team member whose duties may include gathering patient information and relaying this to the physician. There are three types of “independent” practitioners who conduct patient visits and institute treatment plans without the direct involvement or presence of a physician. This model includes Limited, Partial and Near Complete Independent Practice. The authors said that the integration of advanced practice providers continues to evolve and depends on the need of the physician and group. The most information related to the cost effectiveness of advanced practice providers relates to their use in primary care.

Bottom line: As the presence of mid-level providers increases, physicians should be aware of the practice management models available and of their benefits.

Citation: Norris B, Harris T, Stringer S. Effective use of physician extenders in an outpatient otolaryngology setting. Laryngoscope. 2011;121(11):2317-2321.

—Reviewed by Sue Pondrom