How Hospital based practices use mid level?

[doc8689]

I never worked in hospital based setting. I was wondering how hospital based practices use mid levels? Pros and cons of different settings? Specifically what are the warning signs that can impact your productivity.

---

Members don't see this ad.

 

[Mehena]

It's speciality and hospital dependent the way they're being utilized. This has been discussed more as it pertains to hospital oncology practice on the following thread: Private practice management issues

. Fully shared visits, where the NP/PA does all the work and the MD/DO goes in, gives a high-five, co-signs the note and then bills. I do this for new patients who are likely to get chemo so the patient gets to meet the NP/PA early on and won't be surprised if they see them for on-treatment visits or "urgent care" stuff. CMS is f***ing with how they pay for this right now so I'm not sure how this model will change over time.
2. Survivorship/long-term follow up. Basically, early stage breast cancer. These patients can be emotionally exhausting and demanding so this model is fraught with problems unless the person doing it is good at managing anxiety.
3. Same day and on-treatment visits.
4. All of the above (which is how we do it, with varying levels of success).