Better Patient Care Through Physician Extenders and Advanced Practice Providers

Abstract

Physician extenders and advanced practice providers (APPs) are now common in most adult and pediatric orthopaedic clinics and practices. Their utilization, with physician leadership, can improve patient care, patient satisfaction, and physician satisfaction and work/life balance in addition to having financial benefits. Physician extenders can include scribes, certified athletic trainers, and registered nurses, while APPs include nurse practitioners and physician assistants/associates. Different pediatric orthopaedic practices or divisions within a department might benefit from different physician extenders or APPs based on particular skill sets and licensed abilities. This article will review each of the physician extender and APP health care professionals regarding their training, salaries, background, specific skill sets, and scope of practice. While other physician extenders such as medical assistants, cast technicians, and orthotists/prosthetists have important roles in day-to-day clinical care, they will not be reviewed in this article. In addition, medical trainees, including medical students, residents, fellows, and APP students, have a unique position within some academic clinics but will also not be reviewed in this article. With the many different local, state, and national regulations, a careful understanding of the physician extender and APP roles will help clinicians optimize their ability to improve patient care.

Are Canadian orthopaedic surgeons and American orthopaedic surgeons on par? A Canadian practice survey of orthopaedic traumatologists

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Nurse practitioners, physician assistants, and trust: A systematic review

“…Both groups have been employed in the United States since 1967 (Everett et al, 2009), and the majority practice in primary care. Previous research has shown benefits to incorporating NPs/PAs into health care such as increasing quality of care (Mundinger et al, 2000), decreasing length of stay (Collins et al, 2014), increasing quality of work life for physicians (Johal & Dodd, 2017), and benefits to the bottom line (Milewski et al, 2022).…”