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Assistants and Nurses Improve Specialists' Bottom Lines and Reduce Patient Wait Time

Cheryl Clark, for HealthLeaders Media, June 11, 2009

Increasingly in demand, gastroenterology, orthopedic, and dermatology specialists can resolve bottlenecks in their appointment calendars and increase revenue dramatically by using more physician assistants and nurse practitioners to help treat patients, according to a new California Healthcare Foundation study.

However, not all states' scope of practice laws may be sufficiently broad to allow the practice. Also, more postgraduate training programs are needed for PAs and NPs to gain proficiency so they don't have to be trained on the job.

The authors wrote that practitioners who use PAs and NPs reported that outcomes were almost always positive and the time they saved allowed physicians to spend more time with more complex patients.

The California Healthcare Foundation study evaluated six practices across the country that now use PAs and NPs to bridge the gap in providing care to their patients. The study, "Physician Assistants and Nurse Practitioners in Specialty Care: Six Practices Make It Work," was conducted by researchers at the Center for Health Professions at the University of California, San Francisco.

The authors, Catherine Dower and Sharon Christian, interviewed gastroenterologists, dermatologists, and orthopedic specialists who use nurse practitioners and physicians assistants in both hospital and clinic settings in Federal Way, WA; High Point, NC; Salem, OR; Fontana, CA; Gainesville, FL; and Springfield, MO.

The report concluded "these models generally improved access, reduced wait times and proved financially sustainable."

Although third-party payers have varying reimbursement schedules for services provided by NPs and PAs, "when these clinicians independently provide services to patients, Medicare typically reimburses at 85% of the physician reimbursement rates," the researchers wrote.

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