Are Advance Practice Providers Vital Partners in Care Delivery?

Yes. Across the entire continuum of patient care, Advance Practice Providers (APP’s) are playing vital roles in ensuring access and providing exceptional care in our community.  These well-trained caring professionals include Nurse Practitioners (NP’s), Physician Assistants (PA’s), and Certified Registered Nurse Anesthetists (CRNA’s).  From within many private practices of various specialties, to the offices of the NOTCH Federally Qualified Health Center, to here within Northwestern Medical Center, and in other settings throughout the community, APP’s are respected members of the healthcare team.  Even though they are increasingly common members of the care team and relied upon for care by a significant portion of our community, some may not be as familiar with their role and training.

The American Association of Nurse Practitioners’ website explains that NP’s are “advanced practice registered nurses who obtain graduate education, post-master’s certificates, and doctoral degrees” and says, “Nurse practitioners (NPs) are licensed, independent practitioners who practice in ambulatory, acute and long-term care as primary and/or specialty care providers. Nurse practitioners assess, diagnose, treat, and manage acute episodic and chronic illnesses … They order, conduct, supervise, and interpret diagnostic and laboratory tests, prescribe pharmacological agents and non-pharmacologic therapies, as well as teach and counsel patients, among other services.”  They typically have two years of close collaboration with a physician prior to practicing independently.

The American Association of Physician Assistants’ explains that “PAs work in physician-PA teams and are educated in a collaborative approach to healthcare, which improves coordination of care and can improve outcomes.”  It says “PA training programs are approximately three academic years” in length and “require the same prerequisite courses as medical schools. Most programs also require students to have about three years of healthcare training and experience.”  In addition, PA students “then complete a total of more than 2,000 hours of clinical rotations in: family medicine, internal medicine, obstetrics and gynecology, pediatrics, general surgery, emergency medicine, and psychiatry.”

The credential of “Certified Registered Nurse Anesthetists” came into existence in 1956.  The American Association of Nurse Anesthetists website says, “CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals.” They specify that the education and experience required of a CRNA includes “a Bachelor of Science in Nursing or other appropriate baccalaureate degree, a current license as a registered nurse, at least one year of experience as a registered nurse in a critical care setting, and graduation with a minimum of a master’s degree from an accredited nurse anesthesia educational program.” 

We are fortunate to have more than 100 physicians spread across 26 medical specialties caring for our community here in northwestern Vermont.  We are equally fortunate that so many Advance Practice Providers — NP’s, PA’s, and CRNA’s – are also actively caring for our community as integrated partners across nearly all aspects of medical care.  This collaboration allows for timely access to high quality care on our paths to better health.  With this, do not be surprised if you make an appointment at a “physician office” or at a service here at the hospital and you see an APP for at least one of your visits.  Rest assured that you are in good hands within that practice’s integrated team approach.  If you have any question about the roles, scopes of practice, or training of one of your care providers, please ask them. I have no doubt they will be happy to help you understand.  Your health is their top concern and it gives me great pleasure to thank them for being integral parts of the overall effort of caring for our community.

— Jill Berry Bowen, Chief Executive Officer