With the advent of health care reform, both multi-surgeon spine practices and solo practitioners are faced with the challenge of managing the over 32 million Americans that will now have access to health care and remaining both profitable, and efficient while doing so. Part of the solution will be further incorporation of Nurse Practitioners and Physician Assistants into specialty practices to accommodate a larger patient volume in addition to allowing specialists more time to focus on complex conditions.

More patients will have access to care, and these patients will also have choices as to which provider they would like to see (depending on insurance acceptance). Spine surgeons must be progressive in their efforts to manage this influx of patients, and continue to provide high quality care to retain patients long term. Practice optimization and patient flow patterns must be at the forefront of every spine surgeon’s operational plan and will surely be a crucial element in staying profitable.

Both Nurse Practitioners and Physician Assistants have been licensed and practicing in the United States for more than twenty years. During the course of their evolution their roles and responsibilities have expanded immensely to meet the changing needs of both physicians and practices. Now, once again, these roles will change to stay current with the needs of society.

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Unlike other employees, both NPs and PAs are revenue generators. Therefore, if you have an NP or PA currently in your practice and you are not utilizing them in a way that is profitable STOP! Both NPs and PAs are credentialed to care for patients and bill insurance companies for doing so (both in the office and the OR). These professionals should spend as much of their work day focused on those tasks that produce revenue for the practice, leaving other administrative tasks for ancillary office staff to complete. The role of the NP / PA should be complimentary to their physician counterpart, maximizing productivity, efficiency and quality.

In addition to revenue generation, utilization of NPs and PAs allow the practice to see more patients, spend more time with patients, and allows the surgeon to spend needed time with both surgical and more complex conditions. Patient support provided by NPs and PAs in the form of education, referrals and resources serves invaluable in providing both high quality care and retention.

Healthcare is ever changing, and as healthcare professionals we must be able to stay progressive in our abilities to provide high quality care in a cost effective manner. The future holds bright for NPs and PAs, and they will be in great demand to meet the needs of the aging baby boomers and those who did not have access to health care in the past. Spine Surgeons must be cognizant of the most efficient and cost effective way to utilize NPs and PAs to foster practice growth and delivery of high quality care.

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