Advanced practice providers can expand your practice’s ability to deliver great care, improve access, and reduce physician workload.
But for most practice leaders, that’s not what’s happening. Physicians are still stretched thin and everyone’s frustrated.
So, what separates the practices that get it right from everyone else? I recently spoke with one that had figured it out. Their APPs were productive. Their physicians felt supported. And there was no constant tension about who should be doing what.
What they were doing differently turned out to be surprisingly simple. Whether they realized it or not, they had built a stable “three-legged stool”.
The three legs of the stool are:
- A clear scope of work for APPs and for physicians
- A clear understanding of how physicians will collaborate with APPs
- Compensation that reflects the scope and collaboration
When all three legs are solid, the system works. When even one is weak, the whole thing wobbles. Let’s zoom in on scope.
In many practices, APP roles often develop organically over time. They end up doing inbox management, post-op visits, and whatever else the physicians they work with prefer not to do. And beyond that, expectations are rarely defined in a clear, consistent way.
So, two APPs in the same practice may have very different levels of autonomy, responsibility, and productivity based largely on the preferences of the physicians they work with. Perhaps one APP effectively manages their own patient panel while another is only allowed to handle post-op visits and inbox work. And when those two APPs are frequently placed on the same compensation model, which inherently assumes the same expectations for everyone, it’s not hard to see why everyone is bound to be frustrated.
To make matters even more complicated, APP scope is influenced by state law, physician comfort, and practice culture. There’s no universally right or wrong answer. But without an intentional discussion, the APP role is left ambiguous.
And ambiguity is the enemy of performance. APPs in this situation don’t know what success looks like or what level of support they’ll have, physicians aren’t sure what they can rely on, and administrators don’t know what level of productivity to expect.
If you want to strengthen your APP model, test how strong each leg of your stool is.
Ask yourself and your physicians:
- What are our APPs truly responsible for?
- What should physicians continue to own?
- What does ideal collaboration look like?
- What does success mean in this role, operationally and clinically?
You don’t need to redesign everything overnight. Even a clear, written description of the role and responsibilities can dramatically improve your situation.
Because when scope, collaboration, and compensation are all aligned, APPs don’t just fill gaps. They expand your practice’s ability to deliver great care to as many patients as possible in a sustainable way.
