APP's in Rad Onc

[Carotenoid]

The physician is the Advanced Practice Provider (APP).
PAs and NPs are midlevels. Midlevel should not be an offensive term. If it is, then it's not your problem. Do not grant this premise and accept that this is a term that needs to be "politically corrected." So-called providers have different job titles for a reason. I correct administrators when they try and redefine terms like this.

lol I know when I first heard "Advanced Practice Provider" I thought it was like a neurosurgeon who did a fellowship in onc... then subfellowship in GMB and then to reach the "APP" designation he trained to recognize residual tumor by smell... Not sure what is so advanced about - especially NPs (a year's worth of online courses and then "practical experience" at a practice of your choice, which could be a funeral home for all I know")

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[GI_RadOnc]

@Gfunk6 @thesauce I agree there is a large variety of APP quality/education (probably quite similar to the variety of radiation oncologists!). I think the key is to find people with the drive to be independent. I've met some NPs. who were just awesome, experienced nurses... but did not transition to keeping a service day after day; or not having an 'order set' to work out of; and only felt comfortable with their independance to write for labs, antibiotics and silvadene.

Second is to accept that it's a 3-6 month training piece.. in fact; I asked to work with just the new APP and not a resident during this period so I could invest the time long-term! And it's paying off in spades

If there's enough interest, maybe we could move this to the business of radiation oncology; we are trying to formalize our APP expectations here and I would welcome feedback/expertise from others in that area. Quantifying the 'ROI' to administration is hard; when one just measures APP direct revenue from follow-ups, it's not worth it. I'm working on trying to credit our APPs when they follow a patient (that I wouldn't have) and that patient ends up receiving radiation therapy... is anyone else trying this approach?

 

[Mandelin Rain]

We're physicians.

Who cares what anyone else calls themselves? They can have all the letters in the world after their name for all I care. I'll keep my two. No letter envy over here.

 

[evilbooyaa]

@Gfunk6 @thesauce I agree there is a large variety of APP quality/education (probably quite similar to the variety of radiation oncologists!). I think the key is to find people with the drive to be independent. I've met some NPs. who were just awesome, experienced nurses... but did not transition to keeping a service day after day; or not having an 'order set' to work out of; and only felt comfortable with their independance to write for labs, antibiotics and silvadene.

Second is to accept that it's a 3-6 month training piece.. in fact; I asked to work with just the new APP and not a resident during this period so I could invest the time long-term! And it's paying off in spades

If there's enough interest, maybe we could move this to the business of radiation oncology; we are trying to formalize our APP expectations here and I would welcome feedback/expertise from others in that area. Quantifying the 'ROI' to administration is hard; when one just measures APP direct revenue from follow-ups, it's not worth it. I'm working on trying to credit our APPs when they follow a patient (that I wouldn't have) and that patient ends up receiving radiation therapy... is anyone else trying this approach?

Feel free to start a new thread in the private forum - I think figuring out expectations and ROI (the business) is of value for others to learn.

I think some general discussion of APPs as has been done here can be left here.

@Neuronix I certainly empathize with your viewpoint. You have a viewpoint that is shared by many a Rad Onc attending. I just happen to disagree with you on it, which is OK on SDN, although I am cognizant about your professional concerns.

To those who are trying to defend residents covering all inpatient consults (even if the attending doesn't have a resident) - Just call it part of the service mission (which is certainly a piece of residency) and I'll leave it alone. I just think it's silly to call inpatient consults 'an educational experience' for residents.