Non-Physician Providers

Why Non-Physician Providers Are More Important Than Ever


With more doctors nearing retirement and newer doctors increasingly choosing nonclinical careers, many medical practices are looking to non-physician providers (NPPs) to fill the gaps. But there’s another reason to consider hiring “physician extenders” like nurse practitioners and physician assistants: evidence shows they can make a significant difference in improving your patients’ experience—and reduce costs. Here’s how.

The growth of non-physician providers

Over the past 15 years, the number of NPPs has grown substantially, as practices realize that adding these providers to their staff increases both revenue and patient satisfaction, according to a 2014 MGMA report.

The number of NPPs has grown as practices realize these providers increase access to care, patient satisfaction, and revenue.

Both PricewaterhouseCoopers (PwC) and ECRI Institute cited physician extenders as one of the top health care industry trends for 2015, reported Healthcare Finance News. “Looking back 10 or 15 years ago, probably less than a quarter of providers were using extenders broadly. Today you would be hard pressed to find a large hospital staff that is not using extenders in some shape or form,” said Kulleni Gebreyes, director of health services at PwC.

Not only do NPPs reduce the burden on physicians, they also increase access to care and provide patients with affordable care alternatives.

How NPPs help optimize care, cut costs

A new report by PwC’s Health Research Institute (HRI) found that “most primary care teams are not designed to optimize care—or meet consumer demands for convenience and value,” according to an article in Managed Healthcare Executive.

This is partly because the demand for primary care physicians is tough to estimate and often overstated, the article said. The Association of American Medical Colleges estimates the U.S. needs nine primary care physicians for every 10,000 people. However, advanced primary care models estimate the need at much less, according to the PwC report.

Another thing the report revealed was that primary care physicians are spending too much time on administrative work and not enough time “practicing at the top of their license.”

PwC report finds physicians spend too much time on admin, too little time practicing at the top of their license—a costly trend that NPPs can improve.

That’s where NPPs come in. If there are too few doctors or doctors are spending too much time on nonclinical tasks, patients suffer because there are not enough providers to see them all in a timely manner.

“NPPs are essential members of our health care delivery team,” Michael Brohawn, MGMA member and practice administrator at Orthopaedics East & Sports Medicine Center, told “They improve patient care by increasing the efficiency of our physicians which allows them to focus on more acute needs. NPPs also improve patient satisfaction by creating greater access and appointment availability, and they reduce the direct and overhead costs of the practice.”

The cost difference in who is handling a given task can be substantial, PwC’s Kulleni Gebreyes pointed out in Healthcare Finance News. “If you think about health care; labor costs are anywhere between 50 to sometimes 70 percent of your costs. So when you look at extenders, here is a way to provide service at a lower cost per labor.”

What to know before you hire

Before your practice hires a physician extender, however, it’s important to do your research. Every state has different laws governing the NPP’s scope of practice. “As an example, APNs [advanced practice nurses] in 17 states can diagnose and treat patients without physician supervision, whereas physician assistants work under the supervision of physicians in all settings,” Laura Palmer, PACMPE, Senior Industry Analyst at MGMA, told

NPPs can provide up to 80 percent of services in primary care practices with patient satisfaction equal to or better than a physician, and at lower cost.

While MGMA reports that NPPs can provide up to 80 percent or more of services in primary care practices with patient satisfaction equal to or better than a physician, and at lower cost, “MGMA suggests that providers adapt physician supervision to the NPP’s level of training, complexity of tasks, and the nature of the practice,” added

Medical practices also need to realize that there’s heavy competition for these in-demand providers. Employment opportunities for NPPs include urgent care centers, telemedicine providers, and the rapidly growing number of retail clinics, which are predicted to double in 2017, according to data from Accenture. These clinics, which cater to walk-in patients with non-emergent conditions, are almost exclusively staffed by NPPs.

“Retail health clinics are turning into a boon for physician assistants [and nurse practitioners] who prefer to work in primary care but do not necessarily want to be involved with a private practice or hospital setting,” reported “At this point, there is so much work available they really have quite a few choices when searching for employment.”

It’s worth considering whether adding non-physician providers would benefit your practice. For more articles on hiring, retaining, and motivating staff, check out the Practice Management section of our blog.


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