The Impact of Physician Assistants on a Breast Reconstruction Practice

Chao, Albert H.; Yaney, Alexander; Skoracki, Roman J.; Kearns, Patrick

doi:10.1097/sap.0000000000001087

Cited by 8 publications

(21 citation statements)

References 13 publications

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“…12,13 Other studies quantifying the effects of APPs in field found APPs increase the efficiency of attending surgeons. [14][15][16][17] The investigation of the impact of APPs on resident education, particularly surgical resident education, has been limited. Surveys of both surgical faculty and residents have acknowledged that APPs offer benefits in managing the clinical workload while posing a potential threat to resident education.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Furthermore, faculty face constant pressure to be clinically productive, and APPs have been demonstrated to improve surgeon efficiency in multiple studies. [14][15][16][17] APPs, residents, and faculty is the next critical step in this process. Assessing, and then periodically reassessing, the team dynamic as well as satisfaction with the responsibilities of the team members ensures continued satisfaction with these roles over time.…”

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Risks and Rewards of Advanced Practice Providers in Cardiothoracic Surgery Training: National Survey

Blitzer

Tchantchaleishvili

Lou

et al. 2019

The Annals of Thoracic Surgery

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Background. Changes in healthcare have led to increasing utilization of Advanced Practice Providers (APPs), but their role in Cardiothoracic Surgery (CTS) education remains undefined. This study aimed to analyze the extent of APP utilization on the CTS team, their role within the hierarchy of clinical care, and the impact of PEs on CTS training from the resident perspective. Methods. CTS residents' responses to the 2017 Thoracic Surgery Residents Association (TSRA)/Thoracic Surgery Directors Association (TSDA) In-Service Training Examination (ITE) survey regarding the role of APPs in specific clinical scenarios, and perception of APP contribution to residents' educational environment were analyzed. Statistical analysis of categorical variables was performed in SPSS using a Fisher's exact test and Pearson Chi-Square with statistical significance set at p<0.05. Results. Response rate was 82.1% (280/341). The median number of employed APPs was 16-20 and 50.4% (n=141) reported 11-25 PEs at their institution. The median forAPPs in the operating room, floor, and intensive care unit was 3, 3, and 2 respectively. Overall impression of APPs was positive in 87.5% (n=245) of respondents, with 47.7% (n=133) being "very positive" and 40.1% being "positive" (n=112). In general, residents reported greater resident involvement in post-operative issues and operative consults and greater APP involvement in floor issues. 72.5% of residents had not missed a surgical opportunity due to APPs while, 9.6% missed an opportunity due to a APP despite being at an appropriate level of training. Of those that reported missed opportunities, 44% were I-6 residents. There were no significant differences in APPs' operative role based on resident seniority. Conclusions. The overall impression of APPs among CTS residents is favorable, and they more commonly are involved assisting on the floor or the operating room. Occasionally, residents report missing a surgical opportunity due to APPs. There is further opportunity to optimize and standardize their role

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Risks and Rewards of Advanced Practice Providers in Cardiothoracic Surgery Training: National Survey

Blitzer

Tchantchaleishvili

Lou

et al. 2019

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…Chao et al 14 compared efficiency and financial gains after the introduction of PAs in the practice of two breast reconstruction surgeons at an academic health center. They analyzed the data from 1-year period before and 1-year period after the introduction of PAs.…”

Section: Resultsmentioning

confidence: 99%

“…In this perspective, addition of PAs led to net financial gain of ≈$33,533 per year or $2794 per month. 14…”

Section: Resultsmentioning

confidence: 99%

Impact of Physician Extenders and Midlevels in Plastic Surgery

Seyidova

Lin

2022

Plastic &Amp; Reconstructive Surgery

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Background: With the rapidly changing health care marketplace, there is constant pressure on the health care industry to progress and to ensure high-quality and cost-effective service delivery. The aim of this article is to review the economic value and to evaluate the effectiveness and safety of the independent services provided by physician extenders in plastic surgery. Methods: The PubMed database was used to review the literature. The search was performed using key words “plastic surgery AND (“nurse practitioner” OR “physician assistant” OR “physician extenders”). Inclusion criteria were any study that evaluated economic value associated with the integration of the physician extenders as well as safety and effectiveness of the independently provided services by midlevels in plastic surgery. Results: The PubMed search yielded 182 articles. Following evaluation of the titles and abstracts, 27 articles were included in a qualitative review of content. Of these articles, 10 were ultimately included: four that analyzed economic value and six that evaluated effectiveness and safety of the independently provided services by physician extenders in plastic surgery. All four articles were associated with financial gain and six articles demonstrated safe and effective provision of the independently provided services by physician extenders. Conclusions: The integration of physician extenders has the potential to achieve more efficient workflow with well-coordinated and high-quality care for patients. The authors’ review suggests the integration of physician extenders in plastic surgery adds economic value to the practice and improves effectiveness and efficiency of the workflow safely.

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“…9,[14][15][16] With the integration of physician extenders in surgical specialties, there is a significantly reduced direct physician involvement time in patient care without impacting outcomes. 14,16 This time could be used to increase surgical volume or to increase the number of patients seen in clinics. In addition to physician extenders being significantly beneficial on the overall impact on productivity, the financial gains may also offset employment cost.…”

Section: Discussionmentioning

confidence: 99%

Advanced Practice Providers in Plastic Surgery

Seyidova¹,

Chen²,

Lee³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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In the mid-1960s, the rise of the U.S. population and the change in physician training with emphasis on trained medical experts in multiple specialties led to an increased demand for primary care physicians. At the same time, the introduction of Medicare and Medicaid programs improved accessibility to health care for the elderly and people with disabilities or low income, further increasing demand for physicians. 1 This shortage of physicians led to a rethinking of the health care delivery system, creating new nonphysician clinicians (the forerunners of today's midlevel providers) who would take on many routine aspects of health care delivery and work under direct supervision of physicians.This concept led to the inauguration of the first formal physician assistant program at Duke University in 1965, developed by Dr. Eugene A. Stead, Jr., Chairman of Medicine. It proposed to train former military medical veterans, ideal additions to the health care workforce, with their extensive battlefield medical experience. By the end of the 1970s, the majority of physician assistants in practice were ex-military medical corps, and in the public's mind, a physician assistant was associated with a corpsman. 2,3 In the last 50 years since the introduction of the first physician assistant program, education and board certification requirements have become increasingly standardized, with now more than 230 physician assistant schools across the country. [3][4][5][6] In a similar timeframe as the development of the first physician assistant program, Dr. Loretta Ford and Dr. Henry Silver established the first nurse practitioner program at the University of Colorado. Their intent was to train graduate pediatric nurses to provide comprehensive child wellness care and manage common childhood health problems, especially in the rural areas of Colorado. Initially, the introduction of this new role to advance nursing

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The Impact of Physician Assistants on a Breast Reconstruction Practice

Abstract: In breast reconstruction, PAs primarily enhance the efficiency of plastic surgeons, particularly in the clinic, with downstream clinical and financial gains of an indirect nature for surgeons.

Cited by 8 publications

References 13 publications

Risks and Rewards of Advanced Practice Providers in Cardiothoracic Surgery Training: National Survey

Risks and Rewards of Advanced Practice Providers in Cardiothoracic Surgery Training: National Survey

Impact of Physician Extenders and Midlevels in Plastic Surgery

Advanced Practice Providers in Plastic Surgery

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