This year, nurse practitioners and physician assistants made their first-ever appearance on Merritt Hawkins' list of the top 20 most-recruited physician specialties. Many hospitals and health systems are turning to PAs and advanced practice nurses to boost their primary care capabilities in the face of a physician shortage.
Even though provider organizations are increasingly recruiting PAs and APNs and many physicians recognize how mid-level providers can boost volume, there are some barriers to their integration with primary care physicians, according to the Illinois Hospital Association's summer 2013 Physician Issue Brief. Some physicians see APNs and PAs as threats, the brief says, and other barriers to integration include medical liability concerns, training adequacy concerns and gaps in training accommodation.
In order to overcome those barriers and successfully integrate PAs and APNs into a practice, IHA gave the following eight suggestions:
1. Collaborate with the medical staff
2. Educate the medical staff
3. Highlight the benefits of collaboration
4. Establish clear competencies
5. Ensure the mid-level providers are practicing within the state-defined scope of practice
6. Foster open communication among all care providers
7. Develop an infrastructure to support APN and PA services
8. Set reasonable expectations individually based on skill and experience
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