Adding Advanced Practitioners to Your Primary Care Practice? Do Your Homework First

As physicians' schedules become more and more packed, some primary care practices have hired advanced practitioners (APs) to handle routine exams and other procedures. Here’s why it's important to do your homework before following this trend.

Annette Dunn August 1, 2017

As physicians’ schedules become more and more packed, some primary care practices have hired advanced practitioners (APs), such as registered nurses, nurse practitioners and physician assistants, to handle routine exams and other procedures. The result: physicians are free to focus on more complicated cases, and APs can provide a better (i.e., less rushed) experience for patients. While studies suggest this can be a beneficial move, both for patients and practices’ bottom lines, it requires careful planning and thought. Here’s what you should consider before adding APs to your staff.

What's your capacity?
Your physicians are behind on a daily basis, and there’s never room for a same-day add-on. Is your practice at capacity? While it may appear to be so, it’s important to first take a hard look at your existing staff. Could you re-distribute roles to fill gaps? Could you increase the scope of your current APs? Have you defined your models of care—who is doing what, and why? If you haven’t done this type of evaluation, check it off your list before you think about increasing the size of your staff.
Does this approach make sense for your practice?
In thinking of your models of care, will your patients be well served—and satisfied—with seeing an AP instead of a physician? Some patients may not feel comfortable with APs due to misconceptions about credentials or capabilities. Of course, there are ways you can prevent this, such as by making sure your patients are introduced to the entire care team. But for some practices, such as specialty practices, this approach may simply not work.
What are the costs and benefits?
There is certainly plenty of modeling (using MGMA benchmarks) you can do to determine what kind of return on investment you can expect from adding APs to your practice. One thing many practices don’t think about in this arena, however, is insurance reimbursements. Many insurance companies will reimburse less for procedures that are performed by an AP. This, of course, should be factored into your cost/benefit analysis.


What’s next?

With recent research pointing to a shortage of MDs over the next 10 years, physicians aren’t likely to see much relief anytime soon. Incorporating additional APs into your practice may be a viable solution, but do your homework first. At the same time, establish protocols for re-evaluating this approach at a later date. You want to be certain the addition of APs is a smart move for your practice, now and in the future.

How DS+B can help


  1. Financial analysis

To help you gauge your capacity and ultimately your need, we can conduct a financial analysis that sets the benefits against the cost.


  1. Operational modeling

How will you make it work? Through operational modeling, we can help you evaluate potential workflows.


  1. Quarterly review

To assist you in measuring progress, we follow up with quarterly reviews and analyses that examine both the operational (patient care and physician efficiency) and financial (profit and capacity) health of your practice.


For more information, contact Annette Dunn