Urologists making the most of nurse practitioners, physician assistants: It's a matter of time

Urology Times wanted to learn more about urologists' current use of non-physician providers and whether these providers' numbers and responsibilities are expanding, especially given growing concerns about a work force shortage in urology. That may be one reason midlevel providers have seen an increase in responsibilities in recent years.

Despite the work force shortage, Urology Times found that not all urologists have added midlevel providers to their practices.

"My opinion is that we have trained our nurses and technicians well enough so that we can work our office efficiently," Dr. Pessis said. "I do think non-physician providers are important for a number of practices. But there are ways of using a staff efficiently so non-physician providers aren't necessarily needed."

Dr. Pessis is always on the lookout for new physicians, but doesn't feel that non-physician providers could fill the need any better than his current staff does.

"I'm more of a hands-on person and so are my other two associates," he said. "I wouldn't feel any more confident with a PA than with the nurses I have. It's a matter of how much time you take to train them, and letting them know how you want to run your practice."

Midlevels are the new reality

"We are probably on the cusp of doing that," Dr. Monda said. "We've been fortunate enough to attract urologists here. Being in the Northwest and being in a small community, we've actually been able to attract urologists pretty easily.

"We have a fairly big referral center and we've been able to function, although there are times we wonder why we don't have any midlevels to help us. We haven't gotten to the point, however, where we really need it because we've been able to get urologists to play that role."

A practitioner for 14 years, Dr. Monda recognizes that non-physician providers will be the new reality.

"Physician assistants and nurse practitioners have more ability to practice with our oversight versus a nurse who's truly practicing based on my orders," he pointed out. "Some parts of urology are quite complex; others are quite simple. If you stay within treatment parameters on simpler cases, patients may not need to see a urologist for every little thing.