Productivity assessment of physician assistants and nurse practitioners in oncology in an academic medical center.

PURPOSE Demand for oncologists will increase dramatically over the next 15 years. Physician assistants (PAs) and Nurse practitioners (NPs) have been identified as one solution to meet the projected shortages in oncology. It has previously been reported that 56% of oncologists work with PAs and NPs, more than two thirds of whom believe it benefits their practice with some noted productivity advantages. The purpose of this study was to quantify the productivity of PAs and NPs working in oncology in an academic medical center. METHODS A 2-week self-reported time study was performed in a single large academic medical center. Services were categorized as billable, bundled, care facilitation, administrative, and other based on time spent performing services in each category. Current procedural terminology codes were used to determine the economic value of services provided. RESULTS A total of 54 PAs and NPs were included in the final analysis. PAs and NPs reported similar clinical activities. Overall, there was high variability noted in terms of productivity, notably with PA/NP direct billable revenue. Opportunities were identified to improve utilization of oncology PAs and NPs, with suggestions for future research related to PA and NP productivity tracking. CONCLUSION Productivity measurement for PAs and NPs can be challenging. To our knowledge, this is the first study that quantifies PA and NP productivity in oncology according to known economic indicators such as charges and work relative value units.