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Using Nonphysician Providers (Part 6 of 12)

Few things can impact physician workflow and patient access more than the use of nonphysician providers, such as physician assistants and nurse practitioners.

Dermatologists we visited are using physician assistants (PAs) more than other types of caregivers. One practice uses its PA to cover acute cases, which makes more same-day appointments available to patients. Another group sends patients with relatively simple problems (e.g., warts or acne) to its PA. It is also practical to use a PA for follow-up visits or to perform the initial parts of a visit, leaving physicians free to focus on higher-level activities.

Of course, physicians should be sure that any nonphysician provider is practicing within the scope of their license. Each state sets its own definition of what these providers can do. Check with your state medical association for local requirements. Patients tend to like nonphysician providers for their more relaxed style and more open schedules, but at least one practice in our study was obliged by patient complaints to smooth a path for its PA. Physicians introduced the PA to each patient personally and explained that the PA would be conducting just the first parts of the visit.

Hiring Nonphysician Providers

Hiring a nonphysician provider is often a great way to expand practice capacity, lighten the load of overworked physicians, and add relationship-based services many patients crave. But before you hire:

  • First, discuss your plans with an attorney, or check with your state medical board and with payers to ensure you know what your nonphysician provider is and is not qualified to do. States have different opinions on what clinical skills nonphysician providers have.
  • Make certain you need to add year-round capacity, and that a nonphysician provider is adequate to handle the types of patients that are overloading your schedule.
  • Decide before starting your search what type of provider you want, and what role the person plays in your practice. What kinds of cases will she handle? How will patients be allotted to her?
  • Develop a policy for supervising your new provider. At a minimum, regular chart reviews and in-person meetings with a supervising physician are recommended for most specialties.

Here's another unique strategy we observed — rotating nonphysician practitioners. If physicians in your practice tend to feel "ownership" of a particular nonphysician caregiver, it can disrupt scheduling and staff harmony. Consider rotating clinical staff among the physicians so that no single physician uses the same staff member exclusively.

FYI

For more information on physician assistants or nurse practitioners, visit the following Web sites:

Our essay next month will be "Tracking Biopsies and Delivering Results."

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Physicians Practice

Disclaimer: The material above has been prepared by Physicians Practice. It has not been reviewed by the DermQuest Editorial Board for its accuracy or reliability. Reference to any products, service, or other information does not constitute or imply endorsement, sponsorship, or recommendation by members of the Editorial Board.