5 Things to Consider Before You Hire a Physician Assistant or Nurse Practitioner

A tough choice faced by physicians is when it comes to hiring a new member in order to cost effectively expand their practice. Even though it sounds logical to hire another physician, a PA or NP may be a better alternative.

Mid-Level Practitioners (MLPs)
Mid-level practitioners are health professionals with a broad scope of training a create solution in the physician shortage crisis. Mid-level practitioners can be broadly categorized into two categories: Nurse Practitioners and Physician Assistants.

  1. Nurse Practitioners (NPs)
    Nurse Practitioners are registered nurses with a graduate degree, clinical experience and licensed to practice medicine. Nurse practitioners can educate patients, focusing on counseling, health maintenance and disease prevention. Nurse Practitioners can open their own practices with a collaborating physician who does not need to be on site.
  2. Physical Assistants (PAs)
    Physician Assistants are health professionals who work to provide therapeutic, diagnostic and preventive health services under the “supervision” of a physician. They assist a physician’s practice by working autonomously. PA’s examine patients, take medical histories, order and interpret diagnostic imaging and lab tests, form an assessment and plan, assist in surgery and perform minor surgeries autonomously.

Misconception about Mid-Level Practitioners
The most common misconception, that exists relating to the NPs or PAs is that they can’t be equally qualified enough as physicians. Yet, it has been proven that nurse practitioners and physician assistants can perform most of the tasks physicians perform with the same quality.

Need for Nurse Practitioners and Physician Assistants
As more and more patients are getting medically insured, physicians are feeling burdened trying to adjust themselves to the increasing demands of the patients. Since hiring another physician can fall hard on the budget altogether, adding an NP or PA to your staff may be the better answer. Whether it is nurse practitioner or physician assistant, both have the ability to perform most of the same tasks as physicians.

Considerations to Be Made Before Hiring Mid-Level Practitioners
A well planned hiring process can help create a great outcome for the practice sleeking to add a PA or NP to their team. While there are a wide variety of considerations a practice owner must take, here are 5 of the more important ones:

  1. Define Your Goal New Nurse Practitioner or Physician Assistant
    Anyone hiring a PA or NP should primarily identify the goals and needs of the practice to determine how a nurse practitioner or a physician assistant can assist in achieving them. Do you want to hire a nurse practitioner to help manage a growing population, or do you want to hire a physician assistant so as to attract new types of patients (ex. Spanish speaking, young professionals, adolescents, etc…) or extend your services? Do you seek out more professional collaboration? Answering such questions can help fill up the gaps that you currently find within your services.

    Create a detailed plan to outline, not only the tasks you want the mid-level practitioners to help you with, but also confirmations that they is authorized to carry out, in case your goal is to hire them for better collaboration on complex cases. Begin the hiring process after everything is clear within the job description.

    When hiring a physician extender, keep in mind that an ideal workplace is when every individual member of the team works his maximum by providing the services he or she is allowed to provide and let the physicians play their part to perfection.

  2. Scope of Practice
    The second consideration before hiring a mid-level practitioner is to ensure that he is authorized to carry out the tasks you are hiring him for. The scope of practice of an NP or PA varies from state to state so thou should check with your state medical board to see if there are any restrictions on the treatments you intend to have you new PA or NP to handle.
  3. Nature of Patients
    Another common factor to consider when hiring a new mid-level practitioner is the nature of the patients. If you have a practice that is a specialty practice or if you have a very demanding clientele, a PA or NP may not be easily welcomed by the patients. But don’t worry, this is usually the case for only a short time. Practice owners that introduce their new PA or NP as a trusted and qualified member of their healthcare team often set the tone for future interactions with the PA or NP when the doctor may not be present. Another factor when considering the nature of your patients is how complex your patient population is. Are you going to need someone with experience or can you train a new grad?
  4. Proper Articulation of Mid-Level Practitioner
    Many patients who are not familiar with the qualifications of a mid-level practitioner feel as if they are being handed over to someone not qualified enough to be a physician, and this is absolutely not the case. Therefore, a proper introduction of the new nurse practitioner or physician assistant is crucial by the physician in order to clarify the important role he or she will be playing in the healthcare of the patients. The proper introduction will also help emphasize your own role and responsibility at team work, and highlight the energy of your new physician extender in your team.

    It is also essential that the new NPs and PAs be treated as healthcare providers and not as competitors by the fellow physicians. Bottom line, PA’s and NP’s should not be seen as “another employee’, but rather, as a partner in the practice’s healthcare team.
  5. Benefits vs. Cost
    The last consideration, however highly important, is the consideration of finances. According to a 2013 salary report, Nurse practitioners earned about $98,817 and physician assistants earn about $107,268 annually. Depending on the specialty, there salary can be lower or much higher. So how will you be able to manage the costs? Will you be adding new services? Will you be accepting new patients?


Hiring a mid-level provider is a good decision for practices in general. However it is only applicable if the practice sticks to a solid plan. The considerations for the new role of a nurse practitioner or physician assistant should be taken strongly and defined clearly as well, or else the PA or NP may leave as soon as they find a better opportunity. The main focus of hiring a nurse practitioner or physician assistant should be based on the goal of forming a long-term relationship that will improve patient care and the working of the practice.

Do you need more help on making a plan to hire a PA or NP? Do you want guidance on how to maximize the benefits a PA or NP can provide to your practice? I can help. Just send me a message and lets work together to create the practice of your dreams.

Posted on March 9, 2015 and filed under Tips and Advise.