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Help patients understand MD, PA, and NP roles

Hospitalist Leadership Connection, June 30, 2009

Some studies and anecdotal evidence show that patients who are treated by nurse practitioners (NP) and physician assistants (PA) are satisfied with their care—but do they really understand the relationship NPs and PAs have with the hospital or hospitalist service? For that matter, do they really understand the roles NPs and PAs play in their care?

Laura Rosenthal, MSN, ACNP, director of nurse practitioners in the hospitalist medicine service at the University of Colorado Health Sciences Center, has encountered more than a few patients who, after several days in the hospital, report to her that they haven’t seen a physician yet. “I explain that I am their care provider, but if they would like to see an attending physician, I’d be happy to arrange for one to stop by.”

The confusion is understandable—NPs can practice independently in some states, but not in others, and, well, when you’re sick and vulnerable, anyone in a white lab coat looks like a doctor.

Mitchell Wilson, MD, FHM, corporate medical director at Eagle Hospital Physicians in Atlanta, suggests creating a pamphlet or brochure explaining the NP/PA-physician relationship. Also, prepare a “script” that physicians and non-physician providers can use to explain to patients how their care will be delivered. This could be as simple as “Hi, I’m Dr. Wilson, and I work with Ms. Jones, who is a nurse practitioner/physician assistant. We will be talking about your care every day, and I will be in to see you whenever you need me.”

If schedules permit, the physician and NP or PA should visit the patient together so the patient can make the connection between the two. “It is important to have a consistent approach to help patients understand who is seeing them,” says Wilson.

To read more about the hospital-based NP/PA movement, check out the August issue of Hospitalist Leadership Advisor, a supplement to Medical Staff Briefing.

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