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Getting Patients to Trust Advanced Practice Providers


Physicians must demonstrate confidence in their advanced practice providers' abilities and position as a trusted part of the care team.

Advanced practice providers* (APPs) are an integral part of today's better performing practices. You can have a major influence over your patients' acceptance of your APP as an integral and trusted part of your care continuum. Here are eight ways to increase patient trust and acceptance of your APP. Warning: there's no magic pill, it's just common sense and respect.

* Advanced practice provider is a term used to broadly refer to nurse practitioners, physician assistants, and clinical nurse specialists. Advanced practice providers are also referred to as midlevels and physician extenders.

1. Don't blindside patients

Patients don't like surprises, so let your patients know early that you and your APP will share patients. Let them know how you work together - it's important that your patients hear from you that you'll be part of their care, even if you don't see them every visit. Set the parameters and expectations early to avoid surprises that lead to disappointment and/or disillusionment.

2. Avoid the term midlevel

APPs have less training than doctors but more training than a registered nurse, so midlevel might seem to be an appropriate moniker. Research, however, suggests patients perceive midlevels as the second string team, whereas APPs are considered part of the starting team. It's a subtle distinction, but important to many patients.

3. Espouse your APP to patients

When introducing your APP to patients, take 30 seconds to share why she rocks. "Elizabeth has been caring for GI patients for the past twelve years, and she's diagnosed and cared for more IBS patients than most gastroenterologists I know. Together, she and I care for more 1,000 IBS patients every year." If you believe in your APP, your patients will, too.

4. Make it your patient's call

Let your patients know how you will follow their care along with the APP - whether that means seeing them once a year or every third visit. Then ask them if that plan is okay. Nine times out of 10, your patients will agree. Giving them ownership of this decision also gives them ownership of their healthcare. It's a good thing, and it prevents patients from feeling blindsided.  

5.  Confer with your APP

"What do you think?" I love that simple question.  Ask it of your APP while with your patient. When you agree with his assessment, that reinforces your trust in his judgment, and thus, your patient's trust as well. Then ask your patient the same question. Giving her a chance to agree reinforces the patient/APP relationship.

6. What about your website?

Our practice's home page sends the wrong message to patients. You'll see a great photo of 16 physicians. But where are our APPs? If they're such an integral part of our patient care, why don't they get front-page recognition? That's what your patients will wonder - don't make the same mistake I am making.

7. Website profiles

Go beyond a simple listing of your APPs' schooling. Your website is a great place to share their full credentials. "Elizabeth cares for more than 2,000 GI patients every year." "Richard gets more GI training every year than most physicians." "Laura and Dr. Friedman have treated more than 2,500 Hepatitis C patients together."

8. Staff respect

If your staff treats your APP as one of "them" and not one of "you," your patients will sense it. The most effective APPs are those who: 1) Don't try to be one of the gang with employees; but 2) Don't alienate staff with a better-than-thou attitude; and 3) Are treated as a colleague when working with patients and staff. Your staff are critical to patient satisfaction in so many ways; the acceptance of your APPs must be included.

Lucien W. Roberts, III, MHA, FACMPE, is assistant administrator of Gastrointestinal Specialists, Inc., a 21-provider practice in Central Virginia. For the past twenty years, he has worked in and consulted with physician practices in areas such as compliance, physician compensation, and billing/collections. He may be reached at Muletick@gmail.com.

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