The ASCO Study of Collaborative Practice Arrangements—and Beyond

The ASCO Study of Collaborative Practice Arrangements—and Beyond

Heather Marie Hylton, PA-C

Oct 01, 2011
It is with great anticipation that the Results of the ASCO Study of Collaborative Practice Arrangements has now been published in the JOP. Key findings in this important study include:
  1. Physician and nonphysician practitioner (NPP) satisfaction with their collaborative practice model was high.
  2. Patients are aware when they are receiving care from a NPP and report very high satisfaction rates with the care they receive within a collaborative practice model.
  3. Increased productivity was seen in settings where NPPs work with all physician providers.

In reflecting upon these findings, it appears to confirm what we have been observing anecdotally—physicians, NPPs, and patients alike find collaborative practice to be both successful and beneficial. The data from this study are encouraging and provide support for collaborative practice as a workable model in helping to meet the projected demand of oncology services in the future.

Another point of interest in the study was that the survey group was asked to indicate their primary reason for not using NPPs in their practice if they did not do so. The reasons given included difficulty in knowing how to integrate NPPs into the daily workload, budgetary issues, lack of supply of local NPPs, and absence of physician interest in doing so according to the ASCO Annual Meeting Educational Book article by Towle and Hanley. It was also noted that some had previously worked with NPPs but it did not work out.

Together, this information provides a basis for further direction and exploration. Some questions that specifically come to mind include:

  1. How do we optimize the role of the NPP in clinical practice?
  2. What are the barriers to incorporating NPPs into clinical practice?
  3. How can we optimally onboard NPPs?
  4. For practices in which working with NPPs did not work out, what were the issues and how can they be addressed moving forward?
  5. What is the current supply of NPPs in oncology and how do we project the future supply of NPPs in oncology?

Answering these questions may be challenging and will require dedicated and detailed exploration. Ultimately, the answers to these questions will provide the basis for education and guidance on these issues—a necessary step to further optimize the role NPPs will play in meeting the needs of oncology patients in the future.

More to come…


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Catherine S. Bishop, AOCNP, DNP, NP

Oct, 08 2011 10:23 AM

Heather, the results of the suvey were not surprising.  Oncology has embraced the NP and the PA without hesitation. During my doctoral program (2007-2009) I conducted a survey entitled "Cancer Patient's Perception of the Oncology Nurse Practitioner Role in Cancer Management".  The results revealed the oncology NP was an integral member of the healthcare team and respected for the level of care and knowledge in cancer management. The results also demonstrated the hem/onc NP enhanced the patient experience and was a valuable addition to the Hem/Onc practices.  I hope that all of us are attempting to rid the literature of the term "midlevel provider", and Non-physician provider".  Neither term is appropriate even for the sake of convenience. While our roles as NP and PA are similar, we are distinct and must hold on to our titles that are given to us from our respective programs.  We should not allow others to create a different title for us for the sake of lumping us into a category.  I certainly agree with you in terms of the questions that need to be answered.  Perhaps one reason that NPs or PAs did not work out is that some physicians may not understand what our training and education consists of, and one other reason may be that we have not done a good job of standardizing our scope of practice from state to state.  I must also comment that I was disappointed that an NP was not given the opportunity to reflect on the survey.  While I have great respect for Carlton Brown, to my knowledge he is not an NP.  I would have found more parity if a practicing oncology NP would have commented on the survey.
Thank you for your contribution,
Catherine Bishop, DNP, N.P., AOCNP

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