Family Docs and NPs that work together

[Lesassier]

So there is a lot of wasted space on here making circular attacks back and forth on territory and scope of practice. However, I have seen some practices where NPs and family docs actually work together really well to make a clinic flow effectively for their patients.

I think it would be great to hear some constructive examples of how any docs have invited mid-levels into a practice (and in what capacity) to make it more effective. And by the same token in what ways mid-levels would hope to work together with docs.

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[JaggerPlate]

Hire a PA. BOOM. Circle is healed

My Family Practitioner used to have an NP who worked at his office for a while. I hated that woman. Even as a kid, she was just annoying and I didn't like whenever I had to deal with her for something.

 

[montessori2md]

In my experience (maybe 10? clinics with NPs and MDs side by side), how to make the relationship work requires the same stuff that makes hiring anyone to your staff work well. Have a clear description of their job and your expectations on paper when they interview. If, during the interview, you get a wierd vibe, don't think they fit well, don't hire them. Once they are hired, be clear and be nice. Have a set protocol in place for things like chart review, prescribing narcotics/ADHD stimulants/antibiotics. Always be willing to answer a question about a patient, and share interesting stories/articles/patients. If things aren't going well, sit down and explain why, with clear objectives for change (come to work on time, document x in your charts, etc)

I have seen some practices where NPs have their own pt panel, work 100% independently, and others where NPs see the "easy" pts -the well babies, the follow ups, the Depo injections. I have also seen practices where an NP has a niche of patients -for example, all of those 3month DM follow ups, or all the well-woman checks. I've also seen a "multidisciplinary team" using an NP as one of a team consisting of a nurse, 2MAs, an MD, and an NP +/- a counselor or case manager.

 

[senseiturtle]

Hire a PA. BOOM. Circle is healed

+Infinity.


PA's are taught by physicians to help physicians.
NP's are taught by nurses to replace physicians.

My Family Practitioner used to have an NP who worked at his office for a while. I hated that woman. Even as a kid, she was just annoying and I didn't like whenever I had to deal with her for something.

Funny how I can think of several examples of the same. I'm sure some good ones are out there, but I've unfortunately met far too many NP's who had chips on their shoulder and HATED physicians.