Effective use of physician extenders in an outpatient otolaryngology setting

Abstract

Physician extenders may be a valuable asset to an outpatient otolaryngology practice. The adjunctive care provided by physician extenders appears to be cost effective and has the advantages of increasing patient education, promoting physician productivity, and improving management of chronic conditions. Practice types that may benefit from advanced practice providers include group or solo practices with high demand or who need improved efficiency. We discuss five different practice models for incorporation of advanced practice providers in an outpatient otolaryngology practice. These models include scribe, collaborative, limited independent, partial independent, and near complete independent practice and are based primarily on the autonomy level of the physician extender. In additon, we examine available literature discussing the cost effectiveness of physician extenders used in an outpatient setting.

Impact of scribes on emergency medicine doctors’ productivity and patient throughput: multicentre randomised trial

“…16 17 18 Studies from other specialties support the scribe role 1920 21 22 23 Evaluations have shown increased medical productivity,1 12 15 16 20 24 25 but not necessarily faster emergency department throughput, for which the literature is in equipoise 17 10 11 13 15 16…”

Medical scribes in emergency medicine produce financially significant productivity gains for some, but not all emergency physicians

“…Scribe services are being employed in increasing numbers of EDs and offices across the USA. Independent measures of their productivity gains in the ED are limited .…”

Scribes in an Australian private emergency department: A description of physician productivity

“…In other western health systems, EPs are seeing two to three patients per hour with the assistance of medical scribes – the rate depending on the complexity of their patients . Scribes have been used successfully in different ED settings – private, public and academic centres in the USA, also in other speciality office settings . Furthermore these scribe programmes have demonstrated significant cost‐benefit/metric improvement .…”

“…3,4 Scribes have been used successfully in different ED settingsprivate, public and academic centres in the USA, also in other speciality office settings. 3,[5][6][7][8] Furthermore these scribe programmes have demonstrated significant cost-benefit/metric improvement. [3][4][5][6][7] The American College of Emergency Physicians suggests improvements in productivity of about 20% can be expected.…”