Background: Our hospitalist group has seen a rise in the number of Advanced Practice providers (APP) due to increasing patient workload. The APPs come from varying backgrounds, are within 2 years of graduation and have had little experience in evaluating common emergent and nonemergent presentations on the hospital medicine service. Our current practice is for [...]

Background: One way academic organizations recognize staff achievements and scholarly activities is through four levels of academic appointments: Instructor, Assistant Professor, Associate Professor and Professor. Nurse Practitioners and Physician Assistants (NPPAs) employed by the Mayo Clinic are highly encouraged to pursue an academic appointment. A 2016 survey at our three main sites showed that only [...]

Background: The transition of an experienced Registered Nurse into a novice hospital-based Nurse Practitioner (NP) is frequently met with trepidation. The novice NP is often uncertain if s/he possesses the level of clinical competency and scientific knowledge required to provide high quality evidence-based care to complex hospitalized patients. How does one ease the stress associated [...]

Background: The volume of opioid prescriptions in the US has increased dramatically over the last two decades, and strong evidence suggests that this has perpetuated opioid misuse, addiction, overdose, and drug-related deaths. We aimed to learn if there are differences in opioid prescribing among generalist physicians, NPs, and PAs to Medicare beneficiaries. Methods: We performed [...]

Background: The nature of the Advanced Practice Provider (APP) and attending physician (MD) relationship is that of trust, mutual respect, and delegation. In U.S. territories where MD supervision or oversight of APP practice is required by law, MDs are left to trust and delegate patient care tasks and authority to their collaborating APPs while sharing [...]

Background: In the hospital care setting, clinician groups employ a range of staffing models utilizing physicians as well as advanced practice providers (APPs), to meet patient care needs. Models have evolved in recent years in part due to pandemic related staffing constraints; proposed policy changes to billing practices may also be contributing. The Centers for [...]

Background: Physician Assistants (PAs) and Nurse Practitioners (NPs) play a growing role within hospital medicine groups. We studied physician perceptions of NPs and PAs in Hospital Medicine and identified factors that impact these perceptions. Methods: Data was collected through a mixed methodology survey with both open and closed-ended questions on a 6 point Likert scale. [...]

Background: Nurse Practitioners (NPs) and Physician Assistants (PAs) are a vital part of a Hospital Medicine Group (HMG). Many NPs and PAs join HMGs directly after graduating and without prior experience in Hospital Medicine. The anticipation of a new position brings many emotions. There is excitement, but there is also hesitation. The introductory phase in [...]

Background: Newly graduated advanced practice providers (APP) face numerous hurdles in hospital medicine which may hinder the independent practice of APPs. APPs are tasked with assessing, diagnosing, beginning treatments, and discussing recommendations from various specialists with patients and their families. Despite overlapping responsibilities with physicians, there is wide variation in how APPs are prepared, both [...]

Background: One way academic organizations recognize staff achievements and scholarly activities is through four levels of academic appointments (AA): Instructor, Assistant Professor, Associate Professor, and Professor.1 Nurse Practitioners (NPs) and Physician Assistants (PAs) employed by the Mayo Clinic are highly encouraged to pursue AA.1 While NPPAs commonly participate in a wide range of academic activities, [...]