Physician Extenders Bring Host of Benefits to Otolaryngology Practices

Hiring PEs can add up to significant cost savings for an otolaryngology practice as well. The median salary for a full-time PA is $90,873, according to statistics compiled by the American Academy of Physician Assistants for their 2010 census. The median salary for a full-time NP is $94,050, according to a 2011 American Academy of Nurse Practitioners’ survey. By comparison, the median salary of a full-time otolaryngologist is $324,272 in 2013, according to salary.com, making the idea of hiring a non-physician very attractive, particularly for smaller practices and busy practices without a large number of surgical patients.

In addition, the training time for an NP or PA—approximately six years versus 11 to 12 years, plus residency, for an otolaryngologist—means that NPs and PAs will be able to move into patient care faster than full-fledged otolaryngologists and may provide a significant share of health care services as our country heads into a predicted physician shortage in the next decade, according to the Association of American Medical Colleges.

“Anytime you add a new salary to your practice, the revenue has to come from some place,” said Dr. Kuppersmith. “It either has to give you more time, or the NP or PA has to generate more revenue, or some combination thereof. If it wasn’t cost effective, people wouldn’t do it.”

Expanded NP, PA Duties

Neil Bhattacharyya, MD, professor of otology and laryngology at Harvard Medical School in Boston, sees the types of roles and duties tasked to PEs expanding even more in the not-so-distant future, as patient demand for otolaryngologic care increases and the workforce of practicing otolaryngologists ages.

In a recent study he conducted, “Involvement of Physician Extenders in Ambulatory Otolaryngology Practice,” Dr. Bhattacharyya contended that “as the U.S. population ages and with predicted increases in chronic conditions such as obesity, diabetes, and allergic diseases, it is further likely that care provided by physician extenders will increase across multiple medical specialties” and that “APCs are expected to expand in numbers in otolaryngology,” (Laryngoscope. 2012;122:1010-1013).

In terms of what that means for otolaryngology, Dr. Bhattacharyya foresees a larger role for PEs in the management of chronic diseases and more complicated patient care.

“About 50 percent or more of what we do relates to diagnosis and chronic disease management,” Dr. Bhattacharyya said. “In one ideal scenario, physician extenders would do the initial evaluation for new patients and get the appropriate diagnostic testing ordered so that when a patient comes back to see the otolaryngologist for their second visit, everything is in place and the otolaryngologist can arrive at the diagnosis and the plan without the patient having to go for a third or fourth visit.”