We are a team: Collaboration with APPs

by Cynthia Papadopoulos, PA-C, Interim APP Executive Director

The healthcare landscape is changing and so can the way we deliver care.
NP Nurse Midwife

Teaming is the new buzzword, yet many clinicians do not understand the unique relationship that exists between physician and Advanced Practice Provider (APP). To better understand this relationship, we can begin by first realizing that APPs are not intended to replace physicians or any member of the team. Given their unique scope of care and skills, APPs create more robust clinical teams that help optimize the care of patients. In an effective team setting, APPs help ensure physicians and team members are focused on top-of-license care, which helps increase access and quality for patients and can improve the professional satisfaction of the whole team.

Patients today have increasingly more complicated healthcare needs, require assistance with social determinants of health, and have greater choice of where to seek care than they did five years ago. Meeting these challenges requires a team and involving and collaborating with an APP makes that team stronger.

Research by the American Academy of Physicians Assistants (AAPA) has shown that adding an APP to a practice maintains high-quality care, allows teams to meet key metrics, and improves timely access to care. Working as a team has also been shown to reduce physician and caregiver burnout by sharing this demanding workload.

“Having Johna Beard, NP, as a part of our clinical team has been incredibly helpful," says Justin Jones, MD, at Utah Valley Internal Medicine. "Not only has she been invaluable to helping us meet our goal of providing timely access to care to all our patients, she is also a compassionate, skilled clinician who provides first-class care to all of her patients,"

Collaborative teams rather than individuals are most likely to succeed in healthcare today. No two teams are alike, and we can foster creativity by allowing teams to take ownership of how they will best perform together. For some teams this means each physician and APP having a panel of patients and sharing the healthcare needs of those patients. For other teams, it means several physicians working with one or two APPs who provide same-or-next-day access for any healthcare need. They meet metrics together and the panel belongs to the team, not one individual. In specialty care it means training APPs to top of license to increase access, do procedures, and provide follow-up care so physicians are free to do other procedures or rounding in the hospital.

"Having an APP, Reagan Fails, in Orthopedics has been life-changing!" says Ben Robinson, MD, Orthopedics at Sevier Valley Specialty Clinic. "My workload has been significantly lightened and my quality of life has improved exponentially since having him on our team. His skills and assistance in the operating room, clinic, and emergency department greatly improve our efficiency and overall patient care and outcomes. He sees clinics independently, which broadens our footprint and allows more access to care close to home for rural patients. He is vital to the success of our rural orthopedic practice."

The greatest barriers to not meeting these challenges are unsupportive physician partners, poor onboarding of APPs, lack of education to patients on the team approach to healthcare, not offering APPs to patients for appointments, and not utilizing APPs at top-of-license scope. At Intermountain, we need to be diligent about hiring physicians and APPs who want to collaborate and believe in a team-based approach to healthcare. If we address the above barriers and create a culture of collegial clinician support our APPs, physicians, and most importantly our patients will benefit from our delivery of care.