Collaboration Between APPs and Physicians: Why We Know It Matters

Collaboration between healthcare professionals has long been recognized as a key factor in improving organizational success factors. Specifically, collaboration between advanced practice provider (APPs), such as nurse practitioners (NPs) and physician associates (PAs), and physicians has become increasingly important in modern healthcare systems, as it can improve patient outcomes, help alleviate turnover challenges of physicians and APPs, and improve complex care delivery. In this post, we will discuss the benefits of collaboration between two key groups of healthcare professionals, APPs and physicians, and provide practical strategies for healthcare employers to facilitate collaboration and overcome common barriers. When these two groups collaborate successfully towards organizational goals they benefit, as do their patients and employer.

Understanding the Roles of APPs & Physicians

Both Physicians and APPs are licensed, highly trained, healthcare professionals who diagnose and treat illness, disease, and injury. APPs include physician associates and advanced practice registered nurses (APRNs), whereas, physicians include Doctors of Medicine (MD) and Doctors of Osteopathy (DO).

While APPs and physicians have different educational backgrounds and scopes of practice, they share a common goal: to provide the best possible care to patients. Collaboration between these two professions can lead to better patient outcomes and improved organizational performance.

Collaboration between APPs and physicians result in numerous benefits:

1. Improved Access to Care for Patients
2. Enhanced Quality of Care
3. Improved Patient Outcomes
4. Increased Efficiencies Within Scope
5. Improved Overall Quality of Healthcare Delivery

Improved Access to Care for Patients

Collaboration between APPs and physicians can improve access to care for patients. According to the Association of American Medical Colleges (AAMC), there is a projected shortage of 122,000 physicians by 2032 in the United States. This shortage will have a significant impact on patient access to care, particularly in rural and underserved areas. While rural and historically underserved areas are likely to experience the shortages more acutely, the insufficiency of physicians will be felt everywhere. 

While the physician shortage continues to expand, the supply of PAs and NPs is projected to continue to increase. Meaning, APPs can help to fill the expanding gap by providing care services to patients who might otherwise struggle to access care. If APPs and physicians collaborate on care, together they can enhance access to care.

Enhanced Quality of Care

Collaboration between APPs and physicians can improve the quality of care provided to patients. APPs have advanced training and can provide high-quality care to patients. However, they are often not leveraged to the full scope of their practice. Collaboration between APPs and doctors can help to address this issue by allowing APPs to consult with physicians on complex cases. This collaboration can also help to ensure that APPs are practicing within their full scope of practice and following best practices. APPs, additionally, can provide continuity of care and support physician decision-making in those more complex cases, freeing physicians bandwidth.

Improved Patient Outcomes

Collaboration between APPs and doctors can lead to improved patient outcomes. Studies have shown that APPs can provide high-quality care that is comparable to care provided by physicians. For example, a study published in the Journal of General Internal Medicine found that patients who received care from NPs had comparable outcomes to patients who received care from physicians. However, collaboration between APPs and doctors can further improve patient outcomes by allowing for more effective communication around coordination of care. This communication, which is essential to providing high-quality patient care, empowers APPs and physicians to share information, clarify roles and responsibilities, and coordinate care more effectively. Effective coordination helps to ensure that patients receive the right care at the right time and that there are no gaps.

Increased Efficiencies Within Scope

Collaboration between APPs and physicians can help to alleviate the burden on physicians. Physicians are facing increasing demands on their time and resources, and collaboration with APPs can help to lighten their workload. Additionally, there is an increased demand for APP workforce utilization as the care model delivery in large health systems becomes more complex. By collaborating in patient care delivery APPs can practice with more autonomy within their scope of practice- allowing advanced practice providers and physicians to provide higher-quality care to their patients. This can also help to improve physician, NP, and PA job satisfaction - reducing burnout, which is a growing (and costly) challenge.

Improved Overall Quality of Healthcare Delivery

Finally, collaboration between APPs and doctors can help to improve the overall quality of healthcare delivery. By working together, APPs and physicians can share their knowledge and expertise, which can lead to new insights and better practices. Collaboration can also help to foster a culture of continuous learning and improvement, which is essential in modern healthcare systems. By working together, APPs and physicians can help to ensure that patients receive the highest quality care possible.

Strategies for Facilitating APP & Physician Collaboration

To facilitate collaboration between APPs and physicians, healthcare employers can:

• Incorporate joint training and orientation: By providing joint training and onboarding, healthcare employers can ensure that APPs and physicians have a common understanding of their roles, scope of practices, responsibilities, and care model delivery strategy.
• Provide opportunities for shared decision-making: Healthcare employers can encourage shared decision-making by providing opportunities for APPs and physicians to collaborate on patient care plans and treatment decisions.
• Encourage regular communication and feedback: Healthcare employers can promote regular communication and feedback by establishing regular meetings or check-ins between APPs and physicians.
• Establish mentorship opportunities: it is challenging to transition to a new organization or role. When poorly executed, organization’s experience expensive turnover and burnout. Encouraging mentorship with existing medical staff will help your workforce to not only succeed, but thrive, in practice. Additionally, it will help the organization be seen as a supportive and innovative leader in the marketplace.

Overcoming Barriers to Collaboration

Despite the benefits of collaboration, there can be barriers to working together effectively. Some common barriers to collaboration between APPs and physicians include:

• Professional culture: APPs and physicians may have different professional cultures and norms, which can lead to misunderstandings.
• Perceived hierarchy: APPs may feel that they are not as valued or respected by physicians, while physicians may feel that APPs are encroaching on their scope of practice.
• Lack of trust: Collaboration requires trust between APPs and physicians, and a lack of trust can hinder effective collaboration.

To overcome these barriers, healthcare employers can:

• Promote a culture of mutual respect: Healthcare employers can encourage a culture of mutual respect by recognizing the unique strengths and contributions of each profession and emphasizing the importance of collaboration.
• Recognize the unique strengths and contributions of each profession: Healthcare employers can recognize the unique strengths and contributions of each profession by highlighting the importance and vital role each play in providing quality patient care, and providing opportunities for each profession to share their experiences.
• Provide ample learning opportunities for both positions: With the growing shortage and rapidly increasing surge of APPs, paired with the complexity of modern care delivery, the need for support is evident, especially at the start of careers. As physicians receive residency training programs, a successful transition to practice for APPs is equally vital.

Collaboration is Essential Between APPs & Physicians

Ultimately, collaboration between APPs and physicians is essential to providing high-quality patient care and improving organizational performance in healthcare settings and will only continue to become more crucial to organizational success over the next ten years. If you’re interested in learning how you can better support your post-graduate APPs during their transition and better leverage your APP workforce in the delivery of care let’s work together.