What is the impact of NPs on Neurology going to be? Anyone want to take a guess?
NPs and Neurology
- Thread starter chessodoc
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In the inpatient or outpatient world?
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I only work inpatient. They've provided the ability to actually take care of patients while residencies pull back on clinical hours and leave gaps in care, facilitating the designation of non-teaching services.
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I think it will be a little different, in primary care you had practitioners (FM/IM physicians) penetrating into many markets just not in high enough numbers. In neurology, there is a severe lack of physician coverage in large chunks of the country, creating a kind of neurologic wilderness which will be different for a physician extender to break into. As far as I know we're still working under the idea that NPs need to be supervised by someone, which will make it tough for an NP to come into an area that doesn't even have a neurologist for people to see in the region.
I think the whole issue with extenders in outpatient practice is they are able to see the easy routine stuff which is what a physician used to use to make up time for the more complicated and time consuming visits. Example- you have 2 clinic appts whicha re both 15 min time blocks, one is a stable seizure d/o on 1000mg keppra BID with no seizures since last appt and no side effects, and the other is an established migraineur who just got diagnosed with lupus and is having a COPD flare, just had a recent car wreck and has neuroimaging you need to review and oops they have crushing substernal chest pain (but they came to their appointment anyway) and you need to make sure they're not having a heart attack. Without extenders you could count on the softballs to give you some play in your schedule, but with extenders managing the low hanging fruit I don't know where we are going to get our makeup time from.
I think the whole issue with extenders in outpatient practice is they are able to see the easy routine stuff which is what a physician used to use to make up time for the more complicated and time consuming visits. Example- you have 2 clinic appts whicha re both 15 min time blocks, one is a stable seizure d/o on 1000mg keppra BID with no seizures since last appt and no side effects, and the other is an established migraineur who just got diagnosed with lupus and is having a COPD flare, just had a recent car wreck and has neuroimaging you need to review and oops they have crushing substernal chest pain (but they came to their appointment anyway) and you need to make sure they're not having a heart attack. Without extenders you could count on the softballs to give you some play in your schedule, but with extenders managing the low hanging fruit I don't know where we are going to get our makeup time from.
