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Updated: Jul 18, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
The nonphysician provider in the gastroenterology practice
James B Wagonfeld1, Robert F Murphy
1Digestive Health Specialists, 3209 South 23(rd), Suite 340, Tacoma, WA 98405, USA. jimwagonfeld@hotmail.com
Integrating nonphysician providers (NPPs) into practice significantly improves physician workload, patient satisfaction, and practice revenue. This model supports sustainable practice for physicians, especially in specialties with diminishing supply.
Area of Science:
- Healthcare Management
- Clinical Practice Optimization
- Gastroenterology Workforce Studies
Background:
- Physician burnout is a growing concern, impacting workforce sustainability.
- Managed care environments necessitate cost containment strategies.
- Gastroenterology faces challenges with a diminishing supply of specialists.
Purpose of the Study:
- To evaluate the impact of integrating nonphysician providers (NPPs) into a medical practice.
- To assess how NPPs affect practice operations, physician workload, and patient care.
- To determine the financial and satisfaction outcomes associated with NPP utilization.
Main Methods:
- Qualitative assessment of practice functioning before and after NPP integration.
- Analysis of patient access for compensated and noncompensated care.
- Evaluation of physician workload, productivity, and revenue metrics.
Main Results:
- NPP integration transformed practice operations and image.
- Enabled care for noncompensated patients and contained costs.
- Physicians maintained reasonable workloads, focusing on complex cases.
- Decreased physician burnout risk and enhanced productivity and revenue.
- Improved patient and physician satisfaction.
Conclusions:
- Nonphysician providers are crucial for enhancing practice efficiency and sustainability.
- NPPs allow physicians to manage workloads effectively and extend careers.
- Implementing NPPs leads to significant improvements in financial performance and overall satisfaction.
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