William Maples, chief medical officer for the Institute of Healthcare Excellence, a collaborative of health experts in Omaha, Neb., says that along with increasing the capacity to provide care, NPs and PAs may also foster effective teamwork.
"They can help create improved relationships among all members of the team with the patient at the center of the team," he says. "NPs and PAs can model compassionate and kind care, helping the entire health care team embrace behaviors which humanize care and connection to purpose."
Maples recalls that the use of a nurse practitioner in his former oncology practice proved to be a real benefit.
"The extension of high-quality, kind, and compassionate care to our patients allowed me to have better connections with all of the patients we served," he says. "In addition, the professional friendship of my nurse practitioner provided an avenue for emotional support in our daily work."
In her role as a NP in Porterville, Calif., Angela Vera Jackson has observed physicians being over-burdened with mounting paperwork and the increasing medical needs of aging baby boomers. She sees her work as important in allowing the physician to avoid feeling overwhelmed and consequently, less likely to suffer burnout.
"If we can attend to the less complex tasks, it gives the physician more time to allocate to patients who need additional attention," she says.
Jackson tells of a recent patient, himself a doctor, who had suffered a stroke. The workload relief provided by her position allowed the physician to take more time with a fellow doctor than might otherwise have been the case.
Bridget Duffy, chief medical officer for Vocera Communications, a provider of clinical communication solutions in San Jose, Calif., points to the potential for enhanced teamwork.
"Organizations where doctors and nurses, both RNs and NPs, and physician assistants all view themselves as equal and valued partners in patient care usually produce better results," she says.
Of course, as noted in the SERMO survey, some physicians are not convinced of the value of PAs and NPs in limiting burnout, at least on an across-the-board basis.
"Hiring an NP or PA to extend the skills or redirect some of the less demanding responsibilities of a physician may decrease the stress and burnout experienced by some, but may actually increase it for others," says Russell Libby, president and medical director of Virginia Pediatric Group in Fairfax, Va. and a Physicians Foundation board member. He points out that such partnerships may bring an increase in patient visits and associated responsibilities to worry about, with less of the customary control doctors are used to having.
"Physicians expect to control their universe of work and when that gets out of balance, they can experience stress," he says. "Most will have confidence in their own judgment, but being responsible for the actions, outcomes and potential liabilities of others can be overwhelming for some."