There is no questioning the importance of Advanced Practice Providers (APPs) in modern healthcare. The roles of Nurse practitioners (NPs) and physician assistants (PAs) came into existence in the 1960s as a way to mitigate the impact of the emerging primary care physician shortage. Today, these care providers are even more prevalent in healthcare. In fact, it’s a common occurrence for patients to be offered an appointment with an NP or PA as a way to get into the office sooner.
Considering the expanding role that APPs have in our primary care system, healthcare administrators are beginning to focus on their recruitment and retention in the same manner as physicians. Let’s look at some of the differences between APPs and primary care physicians in terms of education, training, and scope of practice, as well as how to increase access to care by recruiting these professionals as part of your staffing plan.
Education and Training Requirements
Interestingly, there is lack of consistency for the education, training, licensure, certification, and scope of practice for APPs. Each of these areas varies significantly from one state to the next. Nurse Practitioners generally achieve education and clinical training at the master’s or doctorate level, along with the completion of at least 1,000 hours of clinical practice in a focused area. The specialized focus is typically in pediatrics, adult, or geriatric medicine. Oversight for NPs is provided by the state nursing boards. To demonstrate how NPs are treated differently between the states, nearly half have laws allowing NPs to practice independently without oversight. All states allow NPs to have prescription writing authority, even for controlled substances.
Physician Assistants are typically trained alongside medical students, for two years before receiving their master’s degree. Before graduating, PA students will have completed 2,000 hours of supervised practice. While state nursing boards regulate NPs, the PAs come under the jurisdiction of the state medical board, and have to practice under a supervising physician. As with NPs, prescribing authority is afforded to PAs; however, Kentucky is the lone state that doesn’t allow PAs to prescribe controlled substances.
Contrasting this training to a typical family physician illustrates one of the reasons why we have a primary care physician shortage. A family practice physician completes 15,000 hours of clinical work through five years of additional training and residency. In that same amount of time and cost, more than 3 NPs could be trained.
Scope of Practice
NPs and PAs have a significant overlap in scope of service when compared to their physician counterparts. For example, in VA hospitals, nearly half of all inpatient services are performed by APPs. Administrators within the VA system are relying heavily on NPs and PAs and recognize that there are only minor differences in a patient’s perception of care. Another area where APPs are being relied upon are in rural and underserved communities. A study published in 2015 by the National Institutes of Health cited NPs are more likely to deliver care in inner cities and rural settings than primary care physicians. Additionally, the study concluded that an increase in the numbers of primary care NPs would serve to expand access to primary care for vulnerable populations.
According to the Bureau of Labor Statistics, demand for NPs and PAs will not be slowing down anytime soon. Both occupations are still listed in the top ten fastest-growing occupations and are expected to grow by up to 30% through 2028. This demand is a sign that healthcare administrators need to treat the recruitment of APPs the same as they do physicians. Here are a few ways that administrators can proactively attract APPs to their organizations.
- Work with local or regional university systems. You often hear of healthcare systems establishing relationships with medical schools to provide opportunities for student doctors. This same approach should be developed for APPs. Bringing advanced practice students into your clinical setting provides you with a perfect opportunity to evaluate how their skills and personality translates to your care team. In the long run, if they are a good fit, you have an excellent opportunity to retain them upon graduation.
- Work with your state’s professional associations. The American Association of Nurse Practitioners (AANP) and the American Academy of Physician Assistants are two organizations that healthcare administrators should have an established relationship. Most states have chapters that support graduating and experienced APPs in their job search.
- Have a social media strategy. While physicians tend to rely more on physician-specific job boards and websites like Doximity, APPs are more prone to utilize traditional social media sites. Many APPs are very active on professional networking sites, such as LinkedIn. Understanding this critical difference between how physicians and APPs use social media can help administrators more effectively tailor their recruitment strategy.
- Be creative with scheduling. Like physicians, APPs value work/life balance and are more attracted to positions that allow flexibility. Healthcare administrators who are expanding their utilization of APPs, need to be creative in developing part-time positions, building in Telemedicine hours, and finding other ways to offer flexibility and variety into their APP schedules.
- Work with a recruitment partner. Finding a trusted recruitment partner has been an essential component of physician recruitment for healthcare administrators for years. As demand for APPs continues to rise, it is becoming increasingly more important for healthcare organizations to expand their reach in finding qualified candidates. Recruitment firms have access to candidates that administrators may not otherwise reach for their vacancy. Finding a recruitment partner that has a nationwide candidate pool, plus the technology and means to cast a wider net, can be the answer to your hard-to-fill vacancies.
Jackson Physician Search can be the trusted recruitment partner that your organization needs. Whether you are looking for physicians or advanced practice providers, our team of experienced healthcare recruiters can help you reach more qualified candidates. Contact us today.