POCN statistics show that nurse practitioners and physician assistants make up 30% of prescribers, account for over 30% of retail Rxs and handle 1.5 billion patient visits annually. They are an increasing influence in a changing healthcare system, their roles are evolving and expanding more than ever before due to doctor shortages and expanded caseloads intensified by COVID-19.
Sponsored by POCN, MM&M’s online expo discussion, “The Evolving and Expanding Role of the NP and PA in Today’s Healthcare Landscape,” gave attendees the chance to hear three experts speak about their work in these unprecedented times: Sacha Ward, Chief Client Officer, POCN; Angela Golden, DNP, FAANP; and David Mittman, DMSc(h), PA, DFAAPA.
We begin with a definition of NPs and PAs as defined by our panelists.
“NPs have provided primary acute and specialty healthcare to patients of all ages and all walks of life for well over half a century now,” explained Golden. “Our job is to assess patients, order and interpret diagnostic tests, make diagnosis and initiate management and treatment plans including prescribing medication.”
“PAs are medical professionals who diagnose, develop and manage treatment plans, prescribe medications and, very often, serve as a patient’s primary care provider,” said Mittman. “They practice in every state in the U.S., in every medical setting and within every specialty.
Ward added that these healthcare professionals are essential under normal circumstances; indispensable in our current pandemic climate. “Since NPs and PAs spend more time with their patients than the average doctor, they know their patients and their patients’ families on a deeply personal level,” says Ward. “For this reason, they have been instrumental caretakers with the rise in the adoption of telemedicine, offering compassionate care even in a virtual setting.”
And now, they’re able to cross state lines. Prior to the pandemic, healthcare professionals would not be able to work in that state without a waiver or supervision agreement. During the national health crisis, many states have loosened these restrictions, allowing NPs and PAs to operate where they’re needed most, without the red tape. If there’s a silver lining in the current health crisis, it’s that it has helped show that PAs and NPs can do their work without supervision.
“Almost everyone I know, including my own practices, have moved to nearly full telehealth,” said Golden. “Many of my colleagues have stepped up to man call centers, or assist county health departments with testing and contact tracing, while others have traveled to states that were in need of assistance thanks to the waivers. The pandemic has shown that we can, with autonomy, in emergency situations, give people access to the healthcare they need; we should not require legislation to practice; we don’t need laws to govern care. It’s part of our ethics.”
Ward, Golden and Mittman agreed that their ethics include ensuring that their patients are educated; that the decisions made about their health are not mandated from up on high, but rather, are a collaboration between themselves and their healthcare provider. That this type of alliance results in greater patient compliance and adherence should come as no surprise — being included in the decision-making process will make anyone more committed to the results. For this reason, the more an NP and PA truly understand a product, the more likely they are to recommend it.
“Webinars are a great way for us to get a pharma company’s updated information,” said Mittman when asked to share the best way pharma can connect with PAs.
“Disease state presentations are really beneficial to the nurse practitioner,” added Golden.
“Following that up with a branded presentation is one of the best ways for us to know about them.”
Ward added that pharma should be identifying key senior leaders within their local NP or PA communities and educating them about their products. In essence, this allows them to become ambassadors of sorts — a valuable asset that can bridge the gap between pharma and consumer. She suggested conducting in-depth research with NP and PA leaders and talking to them in order to understand their perspectives, which all agreed is a great way to hear what the patients want and what they need. Another agreed-upon touchpoint were simple, but effective daily strategies, such as tailoring emails and other communications will make anyone feel seen — nobody likes form letters that may or may not relate to your area of expertise.
“My prescription is as valuable as any other prescription someone writes,” explained Mittman. “But the only way I can write a prescription for your product is if I know a lot about it. I’m always going to write the script that I know most about; the one I’m most comfortable with it. That’s just human nature.”
All told, building bonds with local NPs and PAs, builds loyalty. And while NPs and PAs have long been a conduit between patients and their doctors, that connection is now paramount, as they travel to distant states and jump into areas of need — testing sites, ICUs, urgent care and ERs — in order to provide care where legislative supervision has been removed.
Said Golden in the simplest, most human terms, “We’re just looking for ways to provide the very best care we can where our patients are, and where they need the care.”