Findings from the 2015 AUA Annual Census show wide variation across urologic practices in engagement with advanced practice providers (APPs).
Ongoing research is examining the roles performed by APPs, and ultimately it is hoped that the gathered information will lead to strategies for increasing APP utilization and the associated benefits, said Raymond Fang, director of data management & statistical analysis for the AUA. He reported the findings at the AUA annual meeting.
Fang’s research interest in APP utilization in urologic care stems from a growing trend in APP utilization in specialty care.
“Proper use of mid-level providers can allow urologists time to focus on more complex procedures while lowering health care costs. Integrating APPs into a urologist-led practice team can help increase cost-effectiveness in care delivery, improve patient access to urologic care, and may help address the projected problem of urologist work force shortages,” Fang said.
“First, however, we need to understand the true scope of APP utilization by urologists and reasons for any variation. Our initial analysis gives urologists the first accurate idea of how many physician assistants (PAs) and nurse practitioners (NPs) are working in urology.”
Through a collaborative initiative with multiple institutions across the country, questions on medical team composition were added to the AUA 2015 Annual Census that asked urologists to indicate the total number of urologists, Pas, and NPs working directly with them in their practice team. Using complex survey methods, samples were weighted that would be representative of the entire practicing urologist population in the United States.
Extrapolating from the sample, it was estimated that, in 2015, there were approximately 2,500 PAs and 2,665 NPs working in urology practices across the country. The percentages of urologists working with the two types of APPs varied by practice setting and region. A majority of urologists (50% to ~70%) working in Veterans Affairs hospitals, academic medical centers, and community health center/HMO/managed care organizations worked with PAs. Approximately 75% of urologists in academic medical centers and 56% of those working in VA hospitals worked directly with NPs. Less than 50% of urologists in other practice settings worked directly with either NPs or PAs.