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Midlevel Providers in Orthopaedic Surgery: The Patient's Perspective
Blaine T Manning1, Daniel D Bohl1, Michael L Redondo1
1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL USA.
The Iowa Orthopaedic Journal
|August 16, 2019
Summary
Orthopaedic patients prefer specific tasks for surgeons and midlevel providers, influencing surgeon choice and satisfaction. Patient perceptions of physician assistants and nurse practitioners vary, impacting care delivery models.
Area of Science:
- Orthopaedic Surgery
- Health Services Research
- Patient Care Models
Background:
- Increasing demand for orthopaedic care necessitates integration of midlevel providers (physician assistants [PAs] and nurse practitioners [NPs]).
- Limited research exists on orthopaedic patients' perspectives regarding the roles and importance of midlevel providers.
Purpose of the Study:
- To investigate orthopaedic patients' perspectives on the scope of practice for midlevel providers.
- To understand the importance of midlevel provider training in patient selection of orthopaedic surgeons.
- To assess patient views on reimbursement equity between midlevel providers and orthopaedic surgeons.
Main Methods:
- Anonymous questionnaire administered to 538 new orthopaedic patients before their initial visit.
- Survey content focused on patient preferences for midlevel provider scope of practice, influence on surgeon choice, and reimbursement.
- Data collected from 415 respondents (77% response rate).
Main Results:
- Most patients (68%) considered midlevel provider training when selecting a surgeon; 34% perceived physician assistants (PAs) as more highly trained than nurse practitioners (NPs).
- Patients specified distinct preferences for surgeon-provided services (e.g., initial consultations, abnormal test interpretation) versus midlevel-provided services (e.g., preoperative teaching, minor procedures).
- A consensus on reimbursement equity was lacking, despite most patients (78%) perceiving surgeons as providing higher quality consultations.
Conclusions:
- Patient preferences for task delegation between surgeons and midlevel providers can optimize efficiency and satisfaction in orthopaedic care.
- Midlevel provider training and perceived expertise influence patient surgeon selection, suggesting potential marketing value.
- Understanding patient perspectives on midlevel provider roles is crucial for effective workforce integration and value-driven healthcare delivery.