Nurse Practitioners and Physician Assistants

 

What are the Roles of Nurse Practitioners and Physician Assistants in an Allergy Practice?

What is a Nurse Practitioner? Nurse practitioners (NPs) are advanced practice nurses with a master’s degree and additional clinical training in a particular specialty who provide high quality health-care services similar to those of a doctor. The NP practices under the rules and regulations of the Nurse Practice Act in the state in which they work in addition to being supervised by a physician.  NPs practice in a wide variety of specialties and provide direct care with a unique blend of nursing and medicine. NPs care differs from that of physicians because their foundation originates from having been nurses who have worked at the bedside. This lends them the ability to see patients from a more global, patient- centered focus.  NPs also have the capability of performing many duties.  Specifically, the NP can diagnose and treat chronic and acute health problems, order and interpret diagnostic studies, prescribe medication and other treatments, and provide patient education for health maintenance. 
Physician Assistants (PAs) also work similarly to NPs. Under direct supervision of a physician, a PA can practice medicine, and thus, also has the same capabilities as NPs. While NPs and PAs (often referred to as mid-level providers) function in a clinical setting performing many duties of the physician, Mid-level providers often work closely and consult with a physician to provide optimal quality care. Recently sited in the Academy of Allergy, Asthma and Immunology newsletter, mid- level providers were found to be an asset to an allergy practice.  They state, “The addition of a mid-level provider…can reduce the amount of time patients wait for a new patient appointment and obtain follow-up care, and can increase the ability for the practice to see patients having troublesome asthma or allergy symptoms.  (Wagner, 2008. 24).

Another benefit of the NP/PA is that they are able to provide coverage for allergy injections when the physician is not able to be present in the office with multi-site practices.  As a result, access to care is increased with more hours available for shot coverage per site, and more appointments available for evaluation in office visits.

As an NP or PA at Capital Allergy, the role of these healthcare providers is to enable you to gain better control and understanding of your allergic or respiratory condition. By learning about your condition, you will become more proactive in your health and take better care of yourself.  The NP/PA also participates in the care and treatment of patients with acute exacerbations (sick visits) in addition to health maintenance for chronic conditions.  Ultimately, their goal is to assist you to ensure proper management of your condition by helping you to understand your health needs and set appropriate treatment goals to improve your quality of life.    

At Capital Allergy the NP/PA has the capability of performing several functions as part of a standardized protocol. Under these guidelines, the NP/PA is able to order allergy testing with prick or blood tests for environmental or food allergies, order diagnostic tests such as chest x-rays or CT scans for persistent sinus symptoms, and initiate allergy immunotherapy. Chronic respiratory problems such as asthma can also be managed by the NP/PA by educating you about your health condition and prescribing appropriate medications. Thus, the NP/PA establishes a comprehensive plan of care to better manage your allergies and respiratory problems.  While the NP/PA can manage your health condition overall, the physician is always available to the providers for consultation, and routine visits can be made alternately to follow up with the physician as well.

Overall, the care provided by mid-level providers has been highly regarded. As evidenced by multiple studies, the general public reports a high satisfaction rate with the care they receive from PAs and NPs.  BMJ, 2002; 324:819-823.    Moreover, it was also concluded that the level of care provided by nurse practitioners vs. physicians was comparable. Mundinger, Kane, Lenz, Totten, Tsai, Cleary, Friedewald, Siu, Shelanski. JAMA. 2000; 283: 59-68.    Vol. 283 No. 1, January 5, 2000

In conclusion, physician assistants and nurse practitioners are an asset to healthcare. At Capital Allergy, as with other healthcare settings, the PAs and NPs provide high quality care to patients. They have proved themselves to be an integral part of health education and maintenance, and increase access to care. 

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