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HM13 Session Analysis: Success Stories: How to Integrate NPs and PAs into a Hospitalist Practice


I attended the HM13 breakout session “Success Stories: How to Integrate NPs and PAs into a Hospitalist Practice,” which featured Timothy Capstack, MD, a hospitalist at Maryland Inpatient Care Specialists, James Levy, a physician assistant/hospitalist at Hospitalists of Northern Michigan, Kaine Brown, MD, a hospitalist at Tift Regional Medical Center, and Justin Psaila, MD, a hospitalist at St. Luke’s University Hospital and Health Network. Judging from the attendance, this is a very relevant topic. It seems every group is looking to hire NP/PAs, and most want to learn how to successfully incorporate them into a hospitalist practice.

Dr. Psaila explained the first key to success is hiring “beyond the basics,” meaning that it is not enough to be a good clinician, you must also hire a good fit to your practice culture. Additionally, NPs/PAs need to be part of a team they can rely on. He said critical-thinking skills are a much better asset for an NP/PA than technical procedural skills.

Levy agreed, and noted successful integration starts with getting the “right people on the bus.” HM groups should develop a thoughtful, consistent hiring process—and be willing to cut loose a provider if they are not a good fit. He also thinks it is important to have a lead NP/PA, so new hires know where to turn.

Dr. Brown found successful integration when his group turned to NP/PAs to run the post-discharge transition clinic. His group’s NP/PAs are helping reduce readmissions, improve patient/provider communication, and supporting the social and emotional needs of patients.

Watch a 2-minute video clip of Bob Wachter's HM13 keynote address

Dr. Capstack agreed that HM groups have to “hire right.” Hospitalist NP/PAs need to communicate well and be a team player, but also “know what they don’t know.” If the skill set is right, and you create a culture of collaboration, he said success is guaranteed.

All of the presenters agreed NP/PAs in hospital medicine are here to stay, and that they can be an asset to any HM group. TH

Tracy Cardin is a nurse practitioner in the Section of Hospital Medicine at the University of Chicago.

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