How to use an APP/extender

Boston Red

Full Member
10+ Year Member
Sep 17, 2007
  1. Attending Physician
    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!

    Mandelin Rain

    Full Member
    10+ Year Member
    Apr 21, 2011
      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.
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      7+ Year Member
      Feb 28, 2013
        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.
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