Turnover Among Early Career Advanced Practice Providers in Urology.

Area of Science:

• Urology
• Healthcare Workforce Studies
• Advanced Practice Providers

Background:

• The role of Advanced Practice Providers (APPs) in urology has expanded significantly.
• Early career turnover among APPs in urology is a common but poorly understood issue.

Purpose of the Study:

• To investigate the patterns and predictors of practice movement among APPs in urology.
• To identify factors influencing early career turnover in this professional group.

Main Methods:

• Retrospective cohort study utilizing Medicare data from 2010-2021.
• Identified nurse practitioners and physician assistants new to urology practice billing.
• Employed time-to-event analysis and Cox proportional hazards regression to analyze practice movement.

Main Results:

• Over 30% of identified APPs (307/1003) moved practices, with a median time to movement of 14 months.
• Physician assistants, female APPs, and those in smaller practices were more likely to move.
• The majority of APPs leaving urology transitioned to non-surgical specialties.

Conclusions:

• Practice movement is common for early-career APPs in urology, with many leaving the specialty.
• Clinician type, gender, and practice size are significant factors in APP practice movement.
• Smaller urology practices may need enhanced strategies to improve APP retention, necessitating further research into turnover reasons and retention solutions.