The past few years have been tough financially for medical practices and health systems. To address issues like labor shortages, more and more businesses have started to hire advanced practice providers (APPs).
On Zocdoc, 45 percent of large medical groups, 34 percent of health systems and 25 percent of small practices use APPs, which include nurse practitioners (NPs) and physician assistants (PAs).
Despite this prevalence, a wide-ranging scope-of-practice debate continues to sweep across the US. While advocates say hiring APPs can increase access to healthcare at a lower cost than physicians, critics argue that patients prefer doctors over APPs. They also question their ability to independently provide quality care due to their different medical training. Some states require APPs to practice under a physician supervisor, while others allow them more autonomy.
Zocdoc data shows that most of the concerns surrounding the use of APPs are unfounded and that patients value their interactions with APPs just as much as their time spent with doctors.
“I would say public perception and understanding of advanced practice provider roles has grown astronomically over the past 10 years,” says Chris Hyer, vice president of advanced practice providers at Village Medical, which runs primary care clinics across the country. “And I would say that we still have a lot of education to provide to the public and the community.”
Based on average reviews pulled in October 2022, Zocdoc found that appointments booked with APPs received an average rating of 4.76, while traditional providers received an average rating of 4.79.
By hiring APPs, practices can bring in more patients who are there for the long haul. While some patients might still prefer seeing a physician, over a year, new Zocdoc patients who booked their first appointment with an APP had an average 2 percent higher rebooking rate than patients who booked their first appointment with a physician.
Julie Gessin, chief operating officer of Schweiger Dermatology Group, says APPs in her extensive network of dermatology clinics have “fantastic patient satisfaction.”
For one, NPs and PAs have unique skills that set them apart from doctors. They come from different medical training and diverse professional experiences, which typically grants them great customer service abilities.
“I think the analogy that gets discussed sometimes is that they’re trained to sort of be part of a basketball team, whereas physicians are frequently trained to be golfers,” says Hyer. “That’s not an indictment on physicians. It’s just how training and practice and delivery in care of medicine has gone for years.”
Gessin compares the relationship between doctors and APPs in her clinics to a marriage. Regardless of type of oversight (in-person or remote), a solid foundation of trust allows APPs to operate either independently or collaboratively. “There’s a reason that two people fly most airplanes,” she says.
Some patients simply do not care if they are seeing a physician or a doctor, as long as they’re getting quality care. Experts say that some people, such as those with tight schedules or those living in rural areas with less access to care, just want to get into the doctor’s office.
“What we often find is that patients are just happy to have access to a provider,” says Dr. Ryan J. Wakim, a board-certified psychiatrist, distinguished fellow of the American Psychiatric Association and chief medical officer at Transformations Care Network.