3 questions docs must ask before adding NPPs

In line with predictions, physician practices use more nonphysician practitioners such as nurse practitioners and physician assistants, according to a new report from the Medical Group Management Association (MGMA).

Since 2008, the number of full-time-equivalent (FTE) nonphysician practitioners (NPP) per FTE physician increased by 11 percent, from .27 to .30 in multispecialty practices, the MGMA reported in its analysis, "Nonphysician Provider Utilization in the Future of US Healthcare." Cardiology, family medicine and orthopedic surgery practices have reported an increase in the use of NPPs over the past five years as well.

"Medical practices are evaluating the roles of staff and may be considering employing NPPs in their practice," Laura Palmer, MGMA senior industry analyst, said in an announcement about the report. "This staffing model is being implemented more frequently because it allows NPPs to work at the top of their licensure and ensures physicians more time to devote to complex cases. Staffing a practice in this way can improve access options for patients."

When deciding whether to add NPPs, the MGMA report advises that practices consider where their organizations stand in relation to the U.S. physician shortage, the influx of senior patients and the millions of Americans who gained insurance through the Affordable Care Act.

"Perhaps the most important thing you can do before you hire an NPP is to thoroughly research what your state allows them to do," said Palmer. "State laws governing NPPs' scope of practice can vary significantly. As an example, APNs [advanced practice nurses] in 17 states can diagnose and treat patients without physician supervision, whereas physician assistants work under the supervision of physicians in all settings."

To learn more:
- access the report (.pdf)
- here's the announcement

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