Home Poll A look at nonphysician providers

A look at nonphysician providers

October 2011

Published in the October 2011 issue of Today’s Hospitalist

There’s a lot of talk about the need for hospital medicine to embrace nonphysician providers like NPs and PAs. But how many groups are actually doing so? According to data from the 2010 Today’s Hospitalist Compensation & Career Survey, just under half of all respondents (47%) said their groups had yet to employ any midlevels. That number was slightly lower for adult hospitalists (44.1%) and higher for pediatric hospitalists (58.0%). Here’s a look at other trends from our survey in how hospitalists are using nonphysician providers.

Hospitalist midlevels
Just over half of all hospitalist groups employ midlevels, according to our 2010 data. But how many nonphysician providers do these groups have? The mean number is 3.41. However, groups in facilities that have 250-plus beds have more midlevels on staff (3.74) than groups in smaller hospitals (3.06).

The data also show differences in the use of nonphysician providers by type of practice. National hospitalist management companies that employ nonphysicians tend to have the most, with an average of 4.83 per group. That’s more than employed by universities and medical schools, which reported an average of 3.87.

The type of practice with the fewest number of nonphysician providers is multispecialty/primary care groups, which reported an average of 2.64 midlevels per group.

Geographic effect
Look at how hospitalists are using midlevels by geographic region, and you find some interesting trends.

Midlevels appear to be most popular in the Northeast, probably because of the number of universities and medical schools, which tend to be big users of these providers. Not only are hospitalist groups in the Northeast more likely to use nonphysicians, but the groups that do employ them report hiring more than any other region.

Trends over time
The hospitalists who responded to our survey appear to be embracing the use of nonphysician providers relatively slowly. Data from our 2008 survey show that just under half of all respondents (48.4%) said their groups did not employ midlevels. Three years later, in our 2010 survey, 47% said their groups didn’t employ nonphysician providers.

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