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Sample responsibilities of an NP and PA in a surgical hospitalist practice

Hospitalist Leadership Connection, March 16, 2010

Nurse practitioners (NP) and physician assistants (PA) are physician extenders who function under appropriate supervision, and should neither make final decisions regarding whether a patient need an operation nor perform operations in isolation. The NP/PA:

• Completes and maintains a daily patient log, typically by using the hospital’s computer system
• Rounds on hospitalized patients and provides hospital-based follow-up visits for general surgery patients in the outpatient clinic
• Orders and interprets laboratory studies and x-ray examinations to determine treatment
• Monitors ongoing problems of patients in outpatient clinic, including counseling and coordination of resources.
• Answers phone calls from patients
• Documents a plan of care for physician review
• Assists with discharging patients, dictates discharge summaries, and ensures that referrals for patient follow-up are implemented
• Communicates with families regarding patients’ clinical conditions, expected course of treatment, prognosis, and plan of care
• Acts as first or second assistant to provide retraction, hemostasis, and closure in the OR
• Completes billing in accordance with state and federal billing requirements

The above excerpt is adapted from The Surgical Hospitalist Program Management Guide: Tools and Strategies for Executives and Physicians by John Nelson, MD, FACP, John Maa, MD, FACS, and foreword by Robert M. Wachter, MD, published by HCPro, Inc.

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