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ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE

Medical Practice Strategies:  Systems Based Practice - Business Laws Ethics

Janet Lerman, J.D.

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Class 3  

OFFICE STAFF

Physician Assistants (PAs), Nurse Practitioners (NPs) and Others

PCPs might employ Physician Assistants (PAs) and Nurse Practitioners (NPs) to:

bulletEnable PCPs to concentrate on rendering advanced services
bulletHave staff doing the right work at the right time, increasing the seamless operations of the office 

    According to the article by Robert Lowes, "What Do PA, NP, and CNM Spell?," Medical Economics (March 20, 2000), the answer for physicians is to redefine their roles - specifically, by relinquishing elementary tasks to Nurse Practitioners (NPs) and Physician Assistants (PAs) and concentrating on more advanced ones.

Nurse Practitioners - working with or in place of Family Practitioners, Internists and Pediatriciains:

bulletIn 2002: 82,000
bulletIn  1996:  63,000

Physician Assistants:

bulletIn 2002: 42,700 (Nearly half are in primary care)
bulletIn  1996:  29,000

Source:  Ken Terry, “What’s on the Horizon for Primary Care?,” Medical Economics ( February 8, 2002 ).  

    Deborah Grandinetti, "Make the Most of Your Staff," Medical Economics (April 24, 2000), indicates the importance of having staff doing the right work at the right time so that operations are seamless and that some practices are experimenting with "Care teams".  

    Ken Terr's article, "Re-Engineer Your Practice – Starting Today," Medical Economics (April 24, 2000), looks at same day access, triage nurses, cross-training staff members, and aiming to improve outpatient care.

Make the most of your office staff:
bulletSame day access
bulletTriage nurses
bulletCross-training staff members
bulletAim to improve outpatient care

Coding can be a revenue stream for providers when used accurately.  For example, according to an article in Medical Economics (April 12, 2002), "Low-Level Codes Can Bring in High Revenue:  So Called "Nursing Codes" can be Income Generators if you Use them Correctly", low level office visit codes, such as patient code 99211, often referred to as a "nurse visit" does not require the presence of a physician, nurse practitioner, or physician assistant and is usually provided by an RN or LPN or certified medical assistant.  According to this article, these type of visits are billed as "incident to" services and must follow appropriate guidelines.  Education in proper use of codes is necessary. 

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