How to use an APP/extender

[Boston Red]

Hi All,

Quick question for the community, particularly those that work with extenders (PA-C/NP). How do you feel they are best utilized in clinic to maximize efficiency? I am in a medium PP group, multi site coverage, some sub specializing. We are in the process of hiring an APP, and would love your input on how they are best deployed. Thanks in advance!

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[Mandelin Rain]

They can do pretty much anything you do except consults, treatment planning, standing the way during SBRT, and signing off on IGRT.

At first...Probably best utilized for follow ups (particularly in 90 day global), sporadic OTV issues during non-OTV days, basic supervision if hospital based, and chart prep. Expand role from there. Inpatient issues. Survivorship. Etc... If you do a fair amount of brachy they can save a ton of time with teaching and pre-op issues.

 

[deleted941485]

90 day global and survivorship is where is see the most value day to day. Nothing slows me down more and is more uninteresting. Unless Ofcourse I’m scoping a head and neck.

 

[Bequerel]

I hired one over a year ago and it greatly improves my qol by offloading 1/2 my follow ups and helping with random on treatment issues during non otv days. They will never pay for themselves, but I added an education visit prior to sim with the np. Gets billed as a time based follow-up and helps offset their salary. It’s a great way for np to introduce themselves as part of team, review consult info and go over in more detail expected adverse effects and management during treatment course. This visit has had no issues being reimbursed to the best of my knowledge thus far and patients seem to really enjoy extra visit because they’ve had time to digest info from consult and have new questions.

 

[Chartreuse Wombat]

Follow-ups and pre-simulation/treatment education as Bequerel lists above.