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Physician extenders ease MD shortages

Hospitalist Leadership Connection, April 4, 2007

Nurse practitioners (NPs) and physician assistants (PAs) may be the answer to the physician shortages and resident duty-hour restrictions plaguing many hospitals, according to an article in the May issue of Hospitalist Management Advisor.

At Brigham & Women's Hospital and Faulkner Hospital in the Boston-area Partners Health System, the work-hour restrictions forced the general medicine service practitioners to care for patients in 15 beds that house staff once covered, says Christopher Roy, MD, associate director of the hospitalist service for the two facilities.  

Now, the service has six full-time extenders working on the hospitalist service. The PAs see patients independently, perform histories and physicals, compose care plans, write orders, and call consults. The hospitalists guide the plan. While a hospitalist sees every patient and the PAs and hospitalists round together as part of a multidisciplinary team, the PAs "have become very independent over the last couple years," Roy says. The success of the process is aided by the fact that PAs often come to the program with four or five years of previous inpatient experience. 

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