Should you hire an NP or PA for your facility?

Over the past few years, hospitals, outpatient centers, clinics, and private practices have enlisted the services of nurse practitioners (NPs) and physician assistants (PAs) to help with the physician shortage. These advanced practice providers (APPs), also called mid-level providers, have become a vital component to healthcare staffing.

Ten percent of staffing requests from hospitals and clinics were for mid-level providers, up from a mere 2 percent in 2010, according to 2012 figures.

In fact, various research indicates that incorporating mid-level providers into a facility’s personnel mix pays off financially by maintaining revenue through caring for patients as well as lower salaries than doctors and smaller malpractice premiums.

Other research suggests APPs deliver positive patient experiences. A study by Kaiser Permanente Center for Health Research discovered patient satisfaction for PAs, measured by interpersonal care, confidence in provider, and understanding of patient problems, ranked between 89 and 96 percent. A Berkeley HealthCare Forum review of 16 studies concluded there was no measurable difference in patient satisfaction when comparing NPs and PAs to physicians.

However, just like physicians differ, there are differences between nurse practitioners and physician assistants. If you’re considering adding mid-level providers to your staffing mix, either full-time or as locum tenens, it’s essential to recognize where and how NPs and PAs can best serve your patients.

Nurse Practitioners

• Educational and professional background: The keyword in “nurse practitioner” is “nurse.” Before becoming an advanced practice professional, NPs must first work as a registered nurse, then pursue an advanced degree — usually a master’s but sometimes a doctor of nursing — and obtain additional clinical training. That RN background, however, carries over, so NPs offer expertise in patient education, preventive health, and counseling.

• Practice focus: Assessing, examining, and diagnosing patients as well as prescribing treatment plans and consulting with physicians and other specialists.

• Specialties: Nurse practitioners frequently practice in primary care areas, including family medicine, women’s health, geriatrics, and pediatrics. NPs also specialize in psychiatry, urgent care, cardiology, and orthopedics, among other healthcare specialties.

• Authority: Whether NPs function independently or under the supervision of physicians depends on state law. Twenty-one states and Washington, D.C., allow nurse practitioners to practice independently. Also, NPs possess prescriptive authority in all 50 states and the District of Columbia.

• Settings: Nurse practitioners fit into multiple clinical settings, from acute care hospitals to physician offices. They also practice in clinics, schools, and long-term care facilities.

Physician Assistants

• Educational and professional background: In order to be certified and licensed, physician assistants must complete a master’s degree. PA training mirrors that of physicians, so they present more of a disease-centric approach to patient care.

• Clinical responsibilities: PAs carry out many of the same responsibilities of physicians, including examining and diagnosing conditions, ordering tests, treating some injuries, and offering treatment recommendations

• Specialties: Physician assistants practice in several specialties, such as emergency medicine, surgery, internal medicine, oncology and pediatrics.

• Authority: States determine whether PAs must practice within the scope of supervising doctors. That said, in most cases physician assistants can see patients on their own but consult with doctors. PAs have prescriptive authority in all states, but check with the specific governing body for the details because some states restrict controlled substances.

• Settings: Although PAs work in a variety of clinical environments, their style of practice blends well in acute care, clinics, outpatient centers and private practices.

If you’ve been contemplating adding APPs to your facility or practice, first determine which skill set, specialty focus, and authority level you require and whether nurse practitioners or physician assistants meet those needs. Then evaluate if your staffing demands warrant a permanent hire or if bringing in a locum tenens nurse practitioner or physician assistant for a temporary contract is a more viable solution.

To learn more about how locum tenens mid-level providers can assist facilities meet patient services, contact a Weatherby Healthcare representative.