Force Multiplication: Improving Access to Care and Surgical Conversion Rates Through Implementation of an Advanced...

This study aims to assess the impact of an advanced practice provider (APP)-directed body contouring clinic on improving access, optimizing surgery conversion rates, enhancing patient education on risk factors, and promoting APP autonomy under supervision.

A retrospective chart review was conducted of patients evaluated in the APP body contouring clinic from February 2020 to January 2023 who were interested in reduction mammoplasty, mastopexy, panniculectomy, brachioplasty, abdominoplasty, lower body lift, and/or thighplasty. Extracted data included patient demographics, medical history, reason for consultation, surgery conversion rates, and procedures performed.

A total of 949 appointments were scheduled in the APP clinic, with 836 (88.1%) completed and 113 (11.9%) no-shows. Patients needed to meet specific optimization criteria for a follow-up consultation with the surgeon. Of the patients evaluated in clinic, 381 (45.6%) were not eligible for surgery, representing 191 billable hours. The remaining 455 (54.4%) were referred to a plastic surgeon based on having controlled comorbidities, an HbA1c level of 7.4% or lower, at least 4 weeks of nicotine abstinence, 6 months of weight stability, at least 18 months post-bariatric surgery, a BMI under 40, no hernias, stable breast size, and not breastfeeding. Ultimately, 256 (57.4%) were approved for surgery.

The utilization of APPs in an academic body contouring clinic is a force multiplier, affording greater patient access to care, more efficient use of surgeon consult time, improved surgical matriculation rates and optimized revenue streams through appropriate triage.