One helpful resource Dr. Dewing recommends is the ARP NP/PA Onboarding Toolkit, available in the ACR Education Center. The three webinars available cover why to hire an NP/PA, mentoring your APPs and providing evaluation and feedback.
The Rheumatology Research Foundation also offers one-year $25,000 awards via its Mentored Nurse Practitioner/Physician Assistant Award for Workforce Expansion, Dr. Dewing said. The deadline to apply for this funding is Dec. 1.
Another training option: The 19-module Advanced Rheumatology Course is geared toward health professionals who are new to rheumatology, Dr. Dewing said. It can be pricey, but using grants or awards from the Rheumatology Research Foundation may help.
As you train APPs, make sure to provide feedback, but do it in private—not in front of patients. “I don’t know how many times I’ve heard NPs and PAs frustrated about this,” she said.
Job Satisfaction
You’ve heard it before—a rheumatology practice invests a lot of money and time into familiarizing an APP with rheumatology, only to have them leave the practice. Although there’s no fool-proof way to stop this, you can employ a few strategies to keep them satisfied and sticking around longer:
- Help APPs find a mentor, whether that is someone inside or outside your practice.
- Consider having them work with one dedicated physician, Dr. Edgerton suggested. You can have more than one APP at your practice, but aim for one or two APPs dedicated to working with a specific rheumatologist. The rheumatologist can see a new patient and interpret lab results, and appropriate follow-up care can be managed by APPs, he explained. Learning and implementing one practice pattern, associated with only one physician, may be more tenable and satisfying for an APP.
- Invest in as much education for them as you can. “If education is important, they’re much less likely to leave and reinvest in another specialty,” Dr. Dewing said.
- Provide a specific time when APPs can sit with physicians in your practice for education or to discuss what’s going on in the practice. Sometimes, a Friday lunch can be an ideal time to talk about a case or something specific from the week. “You have to be available. Give them time to ask questions,” Dr. Edgerton said.
- Research salary and incentive options that are standard in your area.
The Challenge of Referrals
Dealing with referrals while the wait time to see patients expands can prove challenging, with no easy answer. “We’re getting a lot more referrals, but it couldn’t come at a worse time as there are fewer of us,” Dr. Edgerton said.
