What is an advanced practice provider?

Increasingly often, when patients make a healthcare appointment thinking they’ll be seen by a doctor, they’re instead seen by a nurse practitioner or physician assistant.

You may wonder what that means for your care.

Nurse practitioners and physician assistants are two examples of “advanced practice providers,” often shortened to APPs.

APPs are licensed clinicians who care for patients in doctor’s offices and hospitals. They can diagnose, treat and prescribe medications, and they work closely with physicians so that you get the right care in a timely manner.

APPs are often more available to handle day-to-day visits, and if something looks more complicated, they can quickly loop in a physician.

What is an advanced practice provider (APP)?

An APP is a trained, licensed healthcare professional who can listen to your concerns, examine you, order and interpret tests, diagnose many conditions, prescribe medications and put together a treatment plan. APPs practice independently, but in collaboration with a physician.

Many communities – especially rural areas – face physician shortages and long wait times. APPs help expand access so you can be seen sooner for routine care and follow-up appointments. This allows physicians to focus more time on the most complex cases.

APPs also can serve as a bridge between patients and physicians, ensuring that patients have access to a doctor if needed.

Types of advanced practice providers (APPs)

Certified nurse practitioners (CNPs)

CNPs provide primary, preventive and specialty care, from annual checkups and bloodwork to management of chronic conditions. They complete a master’s degree or higher plus clinical training.

Physician assistants (PAs)

PAs diagnose, treat and manage care and can assist in surgeries. They complete a master’s-level program and clinical training and typically practice on a physician-led team.

Clinical nurse specialists (CNSs)

CNSs are experts in the nursing plan of care, and they do less diagnosing and treating of conditions in favor of helping with self-care. Many focus on certain populations, such as children or the elderly.

Certified registered nurse anesthetists (CRNAs) and anesthesiologist assistants (AAs)

CRNAs and AAs are specialized clinicians who provide anesthesia care in operating rooms and other procedure areas. They complete a master’s degree or higher and go through specific training in anesthesia care.

APPs must keep their licenses current and are required to participate in continuing education and periodic testing. Many also teach or mentor students, which helps keep knowledge up to date.

Advantages to seeing an APP

Better access

APP appointments are often easier to get, especially for urgent issues that aren’t emergencies.

The right level of care

APPs often manage common conditions and ongoing care plans, allowing physicians to spend more time on more complicated issues.

Follow-up care

Care may start with a physician for initial diagnosis and treatment, and then you may see an APP for follow-ups. This is common for highly specialty care, such as cancer care.

Time for education

APPs often are able to spend extra time on patient questions and education.

How APPs and physicians work together

In a lot of clinics, APPs and physicians function as one team.

• Quick consults: APPs can discuss a case with a physician when something is uncertain or more complex than expected.
• Chart review: Physicians review an APP’s notes and provide guidance.
• Same-visit teamwork: If needed, a physician may join the visit to help make decisions.
• E-consults: Electronic consults allow the care team to get quick expert input as a patient waits for an appointment with a specialist.

Advanced practice providers (APPs) as primary care clinicians

An APP often serves as a patient’s regular primary care clinician, especially if the patient is generally healthy or has stable chronic conditions.

Common reasons patients see an APP in primary care include:

• Annual physicals and preventive screenings
• Routine bloodwork
• Common health concerns
• Long-term management of chronic conditions
• Referrals to specialists, such as physical therapists

When you may need to see a physician instead of an APP

APPs are a great fit for many visits, but sometimes a physician is the best next step.

You’ll likely need to see a doctor for complex issues that need more advanced care or conditions that require highly specialized procedures.

In team-based practices, referrals are streamlined. If needed, an APP can arrange a smooth handoff to a doctor who will have immediate access to your information.