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    How to boost physician productivity through use of extenders

    If physicians want to earn more money, it would seem the easiest option is to see more patients. It’s a simple idea, but quickly bumps up against reality: Even with extra effort, revenue is limited by available time.

    One way to get around this is to add a physician extender—either a nurse practitioner (NP) or physician assistant (PA). An extender can help get more patients through the door by treating routine issues and performing checkups on chronic conditions, allowing the physician to focus on the most serious patient cases. 

    As the industry moves toward more value-based care, a greater emphasis on caring for patients with chronic illnesses can help improve quality scores and increase payments. While not cheap, an extender could help a practice grow revenue by up to 20%, experts say, but only if patient demand warrants the hire.

     “It’s really important that practices always have [available appointments] for their patients,” says Judy Treharne, consulting executive for Columbus, Ohio-based Halley Consulting Group. “This is true not just for existing patients, but also for new patients because of the necessity for a practice to be growing.” 

    If the demand is there, extenders can also add significant profits to a practice’s bottom line, experts say. “Primary care doctors should make $20,000 to $45,000 in profit from an extender,” says Deb Phairas, MBA, president of San Francisco-based Practice & Liability Consultants. 

    Physician assistant or nurse practitioner?

    While PAs are slightly more expensive, Treharne says skill set, not cost, should be the determining factor in the type of extender to hire. 

    NPs, because of their nursing background, typically have a lot of experience assessing and caring for patients in a clinic setting, making them a good fit for primary care practices. “Nurse practitioners have a tendency to be more education-focused,” says Phairas. “They want people to stay healthy and stay out of the office, so this could help you get points for quality measurements.”

    Physician assistants tend to have less prior experience, but typically see more patients because they spend less time on patient education or wellness, Phairas adds.

    Todd Shryock
    Todd Shryock, contributing author

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