On Your Health

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What Are Advanced Practice Providers? What Kind of Care Do They Provide?

As the massive Baby Boomer population ages and more preventive medicine is used to treat chronic conditions, having enough physicians to treat all the patients who need care is a challenge for many health care organizations.

To help with that shortage, advanced practice providers are a growing field of medical professionals filling the void. The Bureau of Labor Statistics estimates that their number in the health care workforce will grow 30 percent by 2024. Advanced practice providers are not doctors, but they have advanced degrees and are qualified to take on some of the roles traditionally assumed by doctors. 

These providers not only help lighten the load for physicians, but also play an important role in value-based care and treatment. They can be a patient’s guide to specialist referrals and can work in conjunction with the patient’s entire health care team to help form a more complete picture of someone’s health, for more optimized care. In addition, they can often provide the medical care a patient needs more quickly and at a lower cost.

What is an Advanced Practice Provider?

An advanced practice provider refers to either a nurse practitioner (NP) or physician assistant (PA), and while they both provide patient care, there are slight differences. For instance, a nurse practitioner is a registered nurse (RN) first. An RN continues his or her nursing education to become a nurse practitioner, earning a master’s-level degree in nursing or a doctorate degree. In general, the care nurse practitioners provide is more patient-centered.

A physician assistant takes pre-med courses in college. When the prerequisites are completed, he or she will apply to a PA program. If accepted, they complete their training in a medical school setting with clinical rotations in multiple areas of medical practice. They graduate with a master’s degree as a PA and sometimes go on to earn a doctorate degree. In general, the care physician assistants provide is more disease-centered.

What Can Advanced Practice Providers Do?

Advanced practice providers work in all areas of medicine and can evaluate, diagnose, develop and implement treatment plans for acute and chronic conditions. For many patients, working with an advanced practice provider is becoming a common occurrence, but there are some limitations in the kind of care they can provide. The role of advanced practice providers varies, depending on the specialty they choose to work in. 

In Oklahoma, nurse practitioners can work autonomously, for instance as a primary care provider, without direct physician oversight, although they must work with a physician collaborator if they are prescribing medication.

According to Janet Fletcher, who is a certified physician assistant with INTEGRIS, “Physician assistants work in a direct relationship with a supervising physician, while their day-to-day practice may not require any direct physician oversight. PA’s are trained to perform many of the same clinical procedures as a physician,” says Fletcher. 

Health care services performed by the physician assistant must be within the physician assistant’s skill and the physician’s scope of practice. PA’s are also only able to prescribe medication under the direction of the supervising physician.

The difference between advanced care providers and physicians comes down to education and training. Physicians have many more years of education and advanced training prior to getting a degree. 

However, advanced practice providers do undergo extensive medical education and generally have master’s degrees (some have doctorates) with an average between six to eight years of education. Like physicians, they must be board certified in the state of their license and are required to have continuing education hours to maintain their licenses.  Nurse practitioners must re-certify every five years, and physician assistants need to re-certify ever 10 years.

How Advanced Practice Providers Work With Physicians

In Oklahoma, advanced practice providers have authority to treat patients and order tests independently and prescribe medication under a physician’s supervision. Some advanced practice providers also work with doctors in operating rooms. 

Typically, in an office visit, advanced care providers will introduce themselves first and give their titles as nurse practitioners or physician assistants. Often, they will be the ones who take your history, perform a physical exam and order lab tests and X-rays if needed. 

“Advanced care providers will then develop a plan of action and review it with the patient, as well as answering any patient questions. If necessary, the advanced practice provider will also consult with the collaborating physician for feedback on the case,” says Fletcher. “The patient has the option to follow up with the advanced practice provider or the physician. Sometimes, seeing a nurse practitioner or physician assistant is the best choice because a patient may be able to get an appointment more quickly,” Fletcher says.

A 2014 Harris Poll found “extremely high” satisfaction rates among Americans who have seen a PA or have a family member who has seen a PA. The survey also showed that 93 percent saw physician assistants as trusted health care providers and 91 percent believe they improve the quality of health care.

A peer-reviewed journal called Critical Care Medicine conducted a review of data published from 2010-2018 which found that advanced practice providers bring substantial value by improving quality of care, enhancing patient safety, enhancing patient and staff satisfaction, providing continuity and decreasing cost of care.

So, the next time you make an appointment and are seen by an advanced care provider, rest assured that you are receiving excellent care by highly trained medical experts.

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