Collegial Relationships: Extending Otolaryngology Practice with Other Professional Providers

The AAPA has some helpful forms at their Web site (see Resources) including a pre-employment checklist and a sample contract outline. Individual state regulations are also available to download at the site. Mr. Brown, who is the president-elect of SPAO–HNS and who has been a member of its board of directors since 1993, frequently answers questions about PAs for inquiring physicians and others who are available to answer questions are accessible through the organization’s Web site. The site also has a link for physicians who want to post job opportunities. SPAO–HNS also annually conducts scope-of-practice and salary/benefit surveys of their members and will share this information with otolaryngologists and office managers.

Nurse Practitioners

Judith Lynch, MS, APRN, FAANP, advises physicians who are interested in working with nurse practitioners that they recognize NPs as professionals working under their nursing licenses who can be used as colleagues in ENT practice settings.

Ms. Lynch, who is employed by ENT Associates in Waterbury, Conn., is an expert on the subject. She taught nurse practitioners at the School of Nursing at Yale and is still on their clinical faculty. “There aren’t many of us working in otolaryngology,” she said. Indeed not. The Society of Otorhinolaryngology Head–Neck Nurses (SOHN) reported that in 1996 there were 34 NPs practicing in this specialty; 10 years later that number had increased to 134.

To her, the benefits of an otolaryngology practice working with NPs overwhelmingly override any drawbacks. Because most otolaryngology practices are comprised of surgeons, with a rare allergist on staff, “there is no one usually available in the office to provide a medical, as opposed to a surgical, approach to care,” she said. Ms. Lynch, who works with three otolaryngologists who have active surgical practices, specializes primarily in vertigo, ear disorders including tinnitus, allergy management, and chronic sinus disease. She has her own panel of patients whom she refers as necessary to the physicians, and they also refer patients to her.

“Having a nurse practitioner in an ENT setting is of great benefit to the patients,” said Ms. Lynch, “because nurses view the patient differently than physicians do. Not that one is better than the other, but they are different [and complementary]. I look at the patient in the context of their lifestyle, how the problem is going to impact their life, their work, their environment.”The difference in education between an otolaryngologist and an NP can be a boon to holistic care. “I tend to take a multisystem approach because my training is so different from the training that my surgical colleagues undergo,” she said.