Nurse Practitioners and Physician Assistants

Role of nurse practitioners and physician assistants at AARA

AARA has 22 nurse practitioners (NP’s) and physician assistants (PA’s) on staff. All play a vital role in our ongoing patient care. Most medical practices around the country now utilize NP’s and PA’s. You may hear them referred to as advanced practice clinicians, mid-level providers, physician extenders etc., but they are licensed as nurse practitioners and physician assistants. In this discussion we will refer to them as Advanced Practice Clinicians (APCs).

Frequently Asked Questions

What is the difference between a nurse practitioner and a physician’s assistant? -click for answer

A nurse practitioner must be a registered nurse (RN) who then returns for university training in advanced practice nursing. NPs subsequently obtain a distinctive license from the nursing board. Physician Assistants often have, but are not required to have, prior ancillary medical experience before entering their university training program. PAs are licensed by the state medical board. Both NPs and PAs are licensed to prescribe medications, order lab, x-ray, MRI, physical therapy etc. Both may review results and make recommendations and provide patient education. Both have some restrictions on prescribing narcotics. Both are required to have continuing education to maintain their license. At AARA, NP’s and PA’s have a very similar role.

At AARA, the APC’s work in collaboration with the physicians to provide quality patient care. On the first visit, one will usually see both an APC and a physician. The APC will obtain your health history and then introduce you to your rheumatologist and present your history. This is very effective because often times as patients listen to their history and symptoms they realize they have left something important out. During this discussion of your symptoms you have the opportunity to add comments and make sure both the APC and your doctor have the true picture of your symptoms and concerns. The doctor will then perform a physical exam and make recommendations. The APC will then get you set up with the needed prescriptions, lab orders etc. Every attempt is made to schedule your 2nd visit directly in with your rheumatologist so you can discuss all the results of your tests etc. Future visits may rotate between the APC and your physician although your physician will direct your plan of care at all times.

At AARA, we maintain a team approach with you, your doctor, the APC, and a medical assistant working together to implement your care. We feel this provides you with the best possible access to all your rheumatologic care needs.

Team Structure of Care at AARA -click for answer

A chronic shortage of rheumatologists exists throughout the US. In most practices, waiting times for a new patient to see a rheumatologist is 2 to 6 months, and many rheumatologists struggle to meet the needs for follow-up care of existing patients. The shortage is projected to worsen over the next 20 years. The American College of Rheumatology has recommended the integration of Nurse Practitioners (NP) and Physician Assistants (PA) as an important way to address this shortage and extend the ability of qualified rheumatologists to meet the demands for specialty care within their communities. As a result, AARA has created teams wherein physicians and skillfully trained and supervised NP/PAs work in a coordinated fashion see patients in a timely manner and reduce the risk of complications of delay. The expanded physician schedules provided by the NP/PAs have successfully reduced wait times substantially, while maintaining the capacity for personalized care.

The value of this integrated model of scheduling with the rheumatologist and their team NP/PAs means that when someone calls for an appointment, a visit can be provided with the minimum of delay. To maintain the success of this strategy, patients will typically see the team NP/PA as part of their first visit with the rheumatologist, and intermittently through the course of care. On any visit, if necessary, patients may be seen by both the rheumatologist and NP/PA.

Therefore, as a policy at AARA, patients are discouraged from insisting on seeing only the physician on the team as this may result in delays and inefficiency in scheduling and needed care.