Physician Extenders in Oncology

ANCO Annual Meeting 2005 Matthew Sirott MD Sarah Buenviaje ONP

NP’s wear many hats Practitioner

Procedures

Quality Enhancer Emergencies

• Manager

• SCUT Worker

• Project Manager

• Financial

E & M Advantages Can see 18 to 24 patients daily Allows MD to see more new consults Easy New Consults Same level of coding = same

collections when MD present in office More time = happier patients Speed New Consults

Procedures Bone Marrow Aspirate and Biopsy Abdominal Paracentesis Omaya access – Intrathecal chemoRx

administration Hepatic pump access Minor punch biopsy Intralesional chemotherapy

Quality EnhancersMore time = happier patientsFemale touchChemotherapy counseling –

formal packet with consent formSecond pair of eyesManagement Team

EmergenciesWalk-in PatientsAdmissionsChemo Suite ReactionsCoverage during MD

emergency

ManagersMedical AssistantsRN’sResearch InterfaceOverall manager (small office)

Project ManagerStandardized ProtocolsTeaching PacketsResearch CQIOrganization and WorkflowCompliance Issues

SCUT WorkerPhone CallsLab ReviewCoumadin managementThalomid re-ordersResearchFlexible – RN, phlebotomy

Financial Increased

Chemotherapy Treatments

Increased E & M, procedures

Maintain workflow because of flexibility

Potential Disadvantages Expensive employee Cannot take call Must have MD present for full billing

capability Increased practice size = increase MD

workload Answering NP questions can take time