Non-Physician Clinicians in GI Practice Part 1: Current Status and Utilization

Moses, Richard E; McKibbin, Ralph D.

doi:10.1038/ajg.2017.16

Cited by 7 publications

(5 citation statements)

References 5 publications

(3 reference statements)

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“…Indeed, approximately half of IBS patients do not follow any dietary plan, and only one quarter of patients are aware of a FODMAP diet in a recently published US survey . The use of physician assistants and nurse practitioners to deliver therapeutic or other interventions that require more time than physicians are able to provide is being actively encouraged as potentially cost‐effective ways of delivering non‐pharmacological therapies . Nevertheless, as patient awareness grows together with the intense search of Internet information, health professionals will be questioned about the FODMAP approach, and many will be ill‐equipped to offer informed advice.…”

Section: Introductionmentioning

confidence: 99%

“…22 The use of physician assistants and nurse practitioners to deliver therapeutic or other interventions that require more time than physicians are able to provide is being actively encouraged as potentially cost-effective ways of delivering non-pharmacological therapies. 23,24 Nevertheless, as patient awareness grows together with the intense search of Internet information, health professionals will be questioned about the FODMAP approach, and many will be ill-equipped to offer informed advice. Furthermore, many patients will initiate dietary change on the suggestion of the multiple Internet sites that are not shy of providing firm advice.…”

Section: Introductionmentioning

confidence: 99%

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Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome

Halmos

Gibson

2019

J of Gastro and Hepatol

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Since its first trial showing evidence of efficacy for managing symptoms of irritable bowel syndrome, the fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has been gaining popularity but not without criticism. Application of the diet has changed from a rigid list of “allowed” and “not allowed” foods to a structured program of initial FODMAP restriction followed by food reintroduction and finally personalization so that patients are empowered to adjust their diet themselves to achieve good predictability of symptoms. Safety concerns of the diet have centered around its initial elimination leading to compromise of nutritional and psychological health, but careful patient assessment and management, preferably through a FODMAP‐trained dietitian, will reduce the risk of such negative health outcomes. Most negative attention for the FODMAP diet has been the notion that it will ruin the microbiota. Controlled studies have indicated that reducing FODMAP intake has no effects on bacterial diversity but will reduce total bacterial abundance, and higher FODMAP intakes will increase health‐promoting bacteria, supporting the concept of the full FODMAP program, including attaining a minimal “maintenance” level of FODMAP restriction. This review addresses all these concerns in detail and how to overcome them, including the use of a “FODMAP‐gentle” diet, describing restriction of a select few foods very concentrated in FODMAPs. This version of the diet is commonly applied in practice by experienced FODMAP‐trained dietitians but is not clearly described in literature. Careful direction and assessment of response or nonresponse will decrease the risks of over‐restriction and under‐restriction of diet.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome

Halmos

Gibson

2019

J of Gastro and Hepatol

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“…Many specialties have also implemented integration of APPs into their practice including gastroenterology and oncology to further augment care, improve patient access, and increase care quality. 16,17 1.…”

Section: Rheumatology Expansion Of App Usagementioning

confidence: 99%

“…This ultimately resulted in an influx of new APPs into rheumatology as depicted in Figure 1. Many specialties have also implemented integration of APPs into their practice including gastroenterology and oncology to further augment care, improve patient access, and increase care quality 16,17 …”

Section: Introductionmentioning

confidence: 99%

Advanced practice providers in infectious disease: Enhancing the infectious disease team of the future

Yoke,

Miller,

Beieler

2024

Transplant Infectious Dis

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As the infectious disease (ID) workforce encounters increasing demand for services with fewer physicians entering the field, advanced practice providers (APPs) in infectious disease offer a unique ability to enhance high‐quality patient care. However, little is known about their incorporation into ID, their utilization in immunocompromised settings, or their future use. This article reviews currently known data on APPs in ID including how some groups have used APPs and provides a framework for thoughtful, deliberate steps to incorporate APPs into the ID medical team, including transplant infectious disease. Highlighted specifically are education and mentorship opportunities with ideas for curriculum development and onboarding approaches. Strategic steps must be taken for APP inclusion as the medical landscape continues to change, patient complexity increases, and the ID team of the future takes shape.

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“…Rapid growth in APP utilization has been demonstrated in the US, including within oncology, gastroenterology, and nephrology, all of which face similar workforce challenges. 16,17,18,19 Several publications have examined the effectiveness of APP care in rheumatology. Solomon et al found that patients seen in practices with nurse practitioners (NPs) or physician assistants (PAs) had lower rheumatoid arthritis disease activity compared to physician-only practices.…”

Section: Editorialmentioning

confidence: 99%

The Challenge of Addressing the Rheumatology Workforce Shortage

Miloslavsky

Marston

2022

J Rheumatol

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The rheumatology workforce faces a deficit of physicians trained to provide high-quality care to patients with rheumatic diseases, and this deficit is projected to worsen over the next 10 to 15 years in many countries and regions around the world. Rheumatology workforce studies carried out in the US, Canada, and in Europe have revealed expected shortages driven by projections for increased demand; changes in demographics among providers, including increasing proportions of women and part-time clinicians as well as high levels of expected retirements; and geographic maldistribution of providers.1,2,3,4,5 In the last 2 years, practice changes caused by the coronavirus disease 2019 (COVID-19) pandemic have affected, and likely exacerbated, workforce limitations.

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Non-Physician Clinicians in GI Practice Part 1: Current Status and Utilization

Cited by 7 publications

References 5 publications

Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome

Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome

Advanced practice providers in infectious disease: Enhancing the infectious disease team of the future

The Challenge of Addressing the Rheumatology Workforce Shortage

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