Comparison of the Quality of Patient Referrals From Physicians, Physician Assistants, and Nurse Practitioners

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

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Practice Model for Advanced Practice Providers in Oncology

American Society of Clinical Oncology Educational Book ◽

10.1200/edbk_175577 ◽

2017 ◽

pp. 40-43

Author(s):

Jamie Cairo ◽

Mary Ann Muzi ◽

Deanna Ficke ◽

Shaunta Ford-Pierce ◽

Katrina Goetzke ◽

...

Keyword(s):

Nurse Practitioners ◽

Professional Growth ◽

Physician Assistants ◽

Advanced Practice ◽

Quality Improvements ◽

Collaborative Relationships ◽

Practice Model ◽

Patients With Cancer

According to ASCO, the number of practicing oncologists has remained stable despite growth demands, leading to an overall shortage in many areas of the country. Nurse practitioners and physician assistants are advanced practice providers (APPs) who can assist in the provision of support and care to patients with cancer, but the role of the APP in the oncology setting has not been well defined. There exists a variety of different practice patterns for APPs who work in oncology, and the lack of role definition and absence of an established practice model are considered leading causes of APP attrition. According to the American Academy of Nurse Practitioners, it has been well demonstrated that, when nurse practitioners are allowed to work to the full scope of their education and preparation, there are notable cost reductions and quality improvements in patient care. The focus of APP education and training is on health promotion, disease prevention, and primary care medical management, but most APPs have limited exposure to management of cancer in patients. With this in mind, Aurora Cancer Care developed a practice model for APPs who work in oncology. The goal of the model is to enhance the quality of care delivered to patients and provide a stimulating work environment that fosters excellent collaborative relationships with oncologist colleagues, supports professional growth, and allows APPs to practice to the full extent of their licensure.

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A Comparison on Quality of Care and Practice Patterns of Primary Care Physicians, Nurse Practitioners, and Physician Assistants for Medicaid Patients in New York

Health Services Research ◽

10.1111/1475-6773.13454 ◽

2020 ◽

Vol 55 (S1) ◽

pp. 88-88

Author(s):

S. Wang ◽

R. Martiniano

Keyword(s):

Primary Care ◽

New York ◽

Quality Of Care ◽

Nurse Practitioners ◽

Primary Care Physicians ◽

Practice Patterns ◽

Physician Assistants

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Efficient and Effective Models for Integrating Advanced Practice Professionals into Oncology Practice

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2013.33.e377 ◽

2013 ◽

pp. e377-e379

Author(s):

Lawrence N. Shulman

Keyword(s):

Health Care ◽

Nurse Practitioners ◽

Physician Assistants ◽

Models Of Care ◽

Advanced Practice ◽

Practice Style ◽

Oncology Care ◽

Oncology Practice ◽

Effective Models

Advanced practice professionals (APP), primarily nurse practitioners and physician assistants, are increasingly being integrated into oncology practices. The reasons are numerous, and models of care options are numerous as well. Models of care have developed without much forethought and are often the result of the relative interests of the physician, the APP, and the mutual “comfort” of practice style. The increasing complexity of oncology care, the pressures of the health care crisis and health care reform mean that it is necessary that we examine models of collaborative care in terms of both quality of care and productivity.

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Linking reimbursement to patient-reported quality of life: Provider perspectives.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.75 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 75-75

Author(s):

Bruce A. Feinberg ◽

Yolaine Jeune-Smith ◽

Stephanie Fortier ◽

Ting-Chun Yeh ◽

Jonathan Kish ◽

...

Keyword(s):

Quality Of Life ◽

Nurse Practitioners ◽

Physician Assistants ◽

The United States ◽

Care Organization ◽

Psychosocial Needs ◽

Incentive Payment ◽

Provider Perspectives ◽

Patient Reported

75 Background: In the value-based era, policymakers have begun incorporating quality of life (QoL) components into payment models, such as the Merit-based Incentive Payment System (MIPs), Oncology Care Model (OCM), and Accountable Care Organization (ACO), to increase accountability. This qualitative research study sought to understand how providers address their patients’ QoL issues in a value-based environment. Methods: A live meeting in September 2019 brought together community oncology healthcare providers (HCPs) from across the United States. Participants submitted their demographic information via a web-based pre-meeting survey and their responses pertaining to patient QoL via an audience response system during the live meeting. Participant responses and their practice demographics were analyzed using descriptive statistics. Results: 71 HCPs participated in this live market research program: 51 medical oncologists/hematologists (herein referred to as physicians) and 20 nurse practitioners or physician assistants (herein referred to as APPs). 50% of physicians and 25% of APPs were from privately owned community practices. Half of HCPs indicated that their practices are collecting and reporting QoL data through value-based programs: 28% of physicians and 60% of APPs were in OCM-participating practices. Regarding accountability, over 80% of HCPs strongly agreed that they have a role in improving patients’ QoL. However, 32% of physicians and 25% of APPs agreed that their payment should be tied to patients’ QoL improvement. According to HCPs, the top factor impacting patients’ QoL was symptom and symptom burden (83%). To address QoL in their patients, HCPs reported addressing patients’ psychosocial needs (78%), implementing survivorship care planning (76%), and using nurse navigators (69%). 70% of physicians and 95% of APPs were confident that their patients have reliable resources for managing their QoL issues. Conclusions: HCPs recognize their role in improving patients’ QoL, and their practices have made several transformations to improve patients’ QoL; they are confident that their patients have resources for managing QoL issues. However, many HCPs disagree with linking QoL improvements to their payment. Further studies are needed to understand QoL from patients’ perspectives in the value-based environment.

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Quality of emergency care provided by physician assistants and nurse practitioners in acute asthma

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2009.01.041 ◽

2010 ◽

Vol 28 (4) ◽

pp. 485-491 ◽

Cited By ~ 20

Author(s):

Chu-Lin Tsai ◽

Ashley F. Sullivan ◽

Adit A. Ginde ◽

Carlos A. Camargo

Keyword(s):

Nurse Practitioners ◽

Emergency Care ◽

Acute Asthma ◽

Physician Assistants

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A Comparison of Nurse Practitioners, Physician Assistants, and Primary Care Physicians’ Patterns of Practice and Quality of Care in Health Centers

Medical Care ◽

10.1097/mlr.0000000000000689 ◽

2017 ◽

Vol 55 (6) ◽

pp. 615-622 ◽

Cited By ~ 59

Author(s):

Ellen T. Kurtzman ◽

Burt S. Barnow

Keyword(s):

Primary Care ◽

Quality Of Care ◽

Nurse Practitioners ◽

Primary Care Physicians ◽

Physician Assistants ◽

Health Centers ◽

Patterns Of Practice

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Introduction

Pain Care Essentials ◽

10.1093/med/9780199768912.003.0001 ◽

2019 ◽

pp. 1-4

Author(s):

Antje M. Barreveld ◽

Beth B. Hogans

Keyword(s):

Nurse Practitioners ◽

Healthcare Professionals ◽

Physical Therapists ◽

Healthcare Providers ◽

Physician Assistants ◽

Early Career ◽

Management Approaches ◽

First Time ◽

Pain Care

Pain has profound effects on human productivity and quality of life. Pain can result in patients experiencing stigma in addition to the profound suffering intrinsic to pain. Since the early 70s, much has been learned about pain through research and collaboration of diverse healthcare professionals and scientists. Despite advances in understanding pain causes, processes, and potential treatments, progress in the preparation of healthcare professionals has been slow. This book represents a collaborative effort of a wide variety of experts in pain, including physicians, nurses, clinical psychologists, pharmacists, scientists, physical therapists and others. The content is organized around learning objectives and targets of the needs of early career health practitioners, including physicians, nurse practitioners, physician assistants, and others. While this book may serve as a refresher, many will be learning this material for the first time. We hope to inspire our readers to engage in meaningful therapeutic partnerships with their patients utilizing the broadest range of effective pain management approaches and therapies with an awareness of safety, pain relief, and the highly individualized nature of pain. Attaining competence in pain care essentials is immensely rewarding for patients, caregivers, and healthcare providers alike.

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