Home Poll A look at nonphysician providers

A look at nonphysician providers

September 2015

Published in the September 2015 issue of Today’s Hospitalist

HOSPITALISTS ARE KNOWN for working on teams with nonphysicians, in no small part because of the ongoing physician shortage. But how successfully are hospitalists staffing their groups with NPs and PAs? According to data from the 2014 Today’s Hospitalist Compensation & Career Survey, groups on average operate at a four-to-one ratio of physicians to nonphysician providers. Here’s a look at how that number varies by location and type of group.

Big employer: academic centers
Our data, which reflect the responses of full-time hospitalists treating adult patients working in groups with at least one nonphysician provider, show that while average groups have 16.9 physicians, they have 4.5 nonphysician providers “a physician to nonphysician ratio of 3.7 to one.

The number of nonphysician providers is highest in groups at universities and medical schools, with an average of six. It’s lowest at national hospitalist management companies, which report an average of only three. But those figures don’t take into account group size. (See “Nonphysician providers by type of group,” below.)

Survey data also show that teaching centers employ more nonphysician providers, regardless of group size. While hospitalists at nonacademic hospitals work with an average of four NPs or PAs, hospitalists on non-teaching services at academic centers report an average of nearly seven.

Regional breakdown
Geographically, hospitalist groups in the Northeast tend to have the most nonphysician providers, with an average of six. That may be due to the large number of academic centers there. The lowest number is in the Pacific region. Programs there report an average 4.4 of just over two NPs/PAs per group, despite the fact that groups in 4.2 that region have significantly more physicians than elsewhere in 2.8 the country.

NPs/PAs and patients per shift
Finally, one survey finding defies any easy explanation: The more patients hospitalists treat per shift, the fewer nonphysician providers they work with. Hospitalists who treat 10 to 14 patients per shift, for example, work with an average of six nonphysician providers, but hospitalists who report treating 15 to 17 patients per shift report working with an average of only four. Groups in which hospitalists see 15 to 17 patients a shift are bigger, so the smaller number of nonphysician providers in those groups isn’t due to group size.