Physician Extenders in Hand Surgery: The Patient’s Perspective

Manning, Blaine; Bohl, Daniel D.; Luchetti, Timothy J.; Christian, David R.; Fernandez, John J.; Cohen, Mark S.; Wysocki, Robert

doi:10.1177/1558944718795303

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…To adopt a similar model, other organizations must first build APP expertise in a collaborative environment. [16][17][18] The concurrent clinic was staffed by a fellowship-trained PA-C who spent 3 months in a collaborative clinic with the physician before being transitioned to the concurrent clinic calendar. Time has to be invested into previsit planning by a designated and experienced resource.…”

Section: Discussionmentioning

confidence: 99%

“…We were able to leverage the ability of a PA‐C who spent a fellowship year for additional training in all aspects of otolaryngology. To adopt a similar model, other organizations must first build APP expertise in a collaborative environment 16–18 . The concurrent clinic was staffed by a fellowship‐trained PA‐C who spent 3 months in a collaborative clinic with the physician before being transitioned to the concurrent clinic calendar.…”

Section: Discussionmentioning

confidence: 99%

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Leveraging Advanced Practice Providers in an Otolaryngology Practice

Sharma¹,

Upjohn²,

Donald³

et al. 2020

Otolaryngol.--head neck surg.

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Objective Advanced practice providers (APPs) may see patients independently or assist in “collaborative” clinics in otolaryngology practices. Our goal was to redesign the collaborative physician-APP clinic model to increase patient access, maintain financial sustainability, and optimize patient and staff experience. Methods The study was performed in a tertiary care academic rhinology clinic seeing adult patients. The DMAIC framework (define, measure, analyze, improve, control) was used to develop the new model. The process shift between old and new models was analyzed by utilizing a statistical process control chart. Patient and staff surveys were tracked. Results The collaborative physician-APP model was redesigned into 2 parallel and independently run (“concurrent”) physician and APP clinics. Patient access increased by 38.9% from a mean of 17.9 patients per collaborative clinic (n = 15 days, 269 patients) to 29.3 patients per concurrent clinic (n = 12 days, 352 patients). Medicare reimbursement rate modeling showed the collaborative clinic to operate at a loss of $1341.51 per day, while the concurrent clinic model operated at a $1309.88 gain (200% positive change). Patient and staff experience tracked positively. Discussion Otolaryngology clinics can become overwhelmed by the volume of empaneled established patients. Traditional collaborative physician-APP clinics see the same panel of patients together. However, these can be successfully redesigned to a concurrent model. Concurrent clinics improve patient access and provider satisfaction while maintaining patient satisfaction and fiscal performance. Implications for Practice Leveraging an experienced APP to run a parallel and independent clinic alongside the physician (concurrent clinic model) may improve patient access, financial metrics, and patient/staff experience.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leveraging Advanced Practice Providers in an Otolaryngology Practice

Sharma¹,

Upjohn²,

Donald³

et al. 2020

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

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“…Administration of antibiotics and venous thromboembolism prophylaxis were more reliable with physician assistants as part of the team, and overall postoperative complication rates were reduced. Additionally, multiple studies have found that advanced practice providers can improve the delivery of safe patient care in critical care, emergency, and general surgery settings [4][5][6][7][8][9][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Initial Evaluation by a Non-Surgeon Provider Does Not Delay the Surgical Care of Pediatric Forearm and Elbow Trauma in a Walk-In Orthopaedic Clinic

Fournier

Neel

Spence

et al. 2020

Cureus

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Introduction Walk-in and after-hours clinics are being increasingly utilized in orthopedics and are especially beneficial for patients with simple sprains, fractures, or overuse injuries that might otherwise require an emergency room visit. To meet the increased patient load, additional staffing often is required, which might include a family medicine physician, nurse practitioner, or physician assistant. Few studies have evaluated the performance of these non-surgeon providers in an orthopedic clinical setting. This study compared the time to definitive care of pediatric patients with forearm and elbow injuries between non-surgeon providers in a walk-in clinic, orthopedic surgeons in a walk-in clinic, and a pediatric orthopedic surgeon in a regular clinic. Methods Children who had closed reduction and fixation of an elbow or forearm injury from January 2010 to December 2017 were identified. The patients were divided into groups: patients initially evaluated in a walk-in clinic by a non-surgeon provider; patients initially evaluated in a walkin clinic by an orthopedic surgeon; and patients initially seen by a fellowship-trained, pediatric orthopedic surgeon in a regular clinic (control group). Neither type of provider (non-surgeon or surgeon) in the walk-in clinics definitively treated any injury but rather transferred care of the patient to a pediatric orthopedic surgeon. The number of clinic visits until surgery, the number of providers seen, the days before evaluation by a pediatric orthopedic surgeon, and the number of days before definitive surgical treatment were documented.

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