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3 Ways to Tame Tensions Between Physicians and APCs

Analysis  |  By Debra Shute  
   November 30, 2017

Advanced practice clinicians are crucial to helping health systems ensure patient access, but numerous factors can undermine team-based care if left unchecked. 

Despite health systems' essential need to embrace team-based care, physicians aren't always crazy about working with advanced practice clinicians, and vice versa. Clinicians rarely complain out loud, however, and often enter into collaborative contracts when they'd rather be in charge.

Ignoring that elephant in the room comes at a cost, says Liana Orsolini PhD, RN, ANEF, FAAN, care delivery and advanced practice system consultant at Bon Secours Health System in Marriottsville, MD.

For starters, when tensions get bad enough that a nurse practitioner or physician assistant quits (often with a mere two weeks' notice), it costs roughly $150,000 to recruit and hire a new APC, says Timothy Willox, MD, chief medical officer for Bon Secours Virginia Medical Group.

Related: Hard-Nosed About Physician Teamwork

To help promote better teamwork from the get-go, consider the following steps:

1. Clear a Landing Spot

Part of physicians' reluctance to work with APCs is generational. If a physician has worked on his own for 30 years, notes Orsolini, changing the model may be a tough sell. "And you've got to respect that," she says.

Rather than waiting for problems to arise, identify any animosity or discomfort upfront, says Willox. "You've got to work through that before you even bring in an APC."

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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