PA/NP in Physician Champion / Advisor Role

don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
edited May 2016 in CDI Talk Archive
Wondering, has anyone experience or thoughts with either a PA or NP functioning in a physician advisor role?

Of course, need the right person -- personality, quite a bit of experience, great clinician, great knowledge base built up through ongoing study as well as very well respected among the medical staff (both directly working with and various consultants).

The role would include education & out reach to the medical staff (both group and one on one), direct support on difficult clinical cases for CDS & coding, as well as chart review for CDI (typically screened cases after coding but before billing).

Thanks,
Don

Comments

  • robert.hodges2robert.hodges2
    Why not? If you have the right person, it should work out well.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    No, but I am sure the clinical support of an NP or PA would be valuable. We have no official advisor, and we do pretty well - an official 'go-to' would be helpful.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    My concern would be whether the providers would be receptive to education and conversation regarding their documentation from an NP. I know in my case, I depend (or try to) on my PA when I can't get through to a MD. Unfortuantely, if they are unwilling to listen to me, they may be unwilling to listen to an NP/PA. I wish this wasn't the case of course, but often I think it is. The point of a PA, in my opinion, is to provide peer-to-peer feedback. I'm not sure if some physicians would agreet aht NP.PA's are "peers".
    That being said, our NP's are (in general) our best documenters and they are also very receptive to the education we provide. So I cans see the value in including them I think whether they would be effective in the role of a PA would depend on the culture of your facility and their personality. There is no "across the board" rule.
    I recently heard a lecture on the role of the PA (for another closely linked program) and it was interesting to hear some of the PA options. There were discussions about choosing a retired but well-respected MD, etc. I'll admit, I had not thought of these options...

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    Good points.
    I agree with Mark and Paul regards the benefit and help potential.
    However, as Katy points out, one of the roles of an Physician Advisor is that peer to peer conversation and the NP/PA may be at a disadvantage.

    As a larger facility, with (I believe) the support and recognition of the ROI to have several individuals in a PA role (part time), I believe that helps to diminish the specific concerns.
    For us, if we pursue this idea, the PA/NP would certainly be part of a group that would also include physicians.

    So far, no one has spoken up with direct experience -- perhaps no one has had a PA/NP in an advisor role?
    I do remember hearing of a PA/NP working in the traditional CDS role.

    Thanks!
    Don
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    I think the reality is our institutions endorse the 'concept' of an MD CDI advisory, but they expect this person to 'volunteer' their time. In my view, a paid and official MD-Advisor would be a huge asset for any hospital and well-worth the investment.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    Whole heartedly agree!!

    Finding the right physician, who is then willing to learn & function in the role is a significant challenge.

    We currently have a full time physician whom is 50/50 UR/CM and CDI -- but the reality is shifted a bit toward the UR/CM side. This physician is functioning more on an executive & medical staff leadership level, and though that is very important, we are lacking the support on a daily operational level.

    We'd like to have at least one additional Physician (or perhaps PA/NP as I discussed below) or several providers on a part time basis operating more on the daily and the individual physician relation basis. And yes, I'm more than happy to pay.

    Our first iteration with physician advisors was to seek volunteers who would be willing to devote a few hours a week (in addition to not instead of their current activities) that would be compensated. Physicians as a whole were too busy to be able to maintain.

    Don
  • Unknown
    edited May 2016
    I feel so blessed. We have two physician advisors and one "unofficial"
    champion for four hospitals. Yes their time is stretched but they always
    come thru for me. It is a wonderful thing to have the physicians to help
    you bridge the gap between you and their peers!

    Jamie Dugan RN
    Clinical Documentation Improvement Specialist
    Baptist Health System
    office:904-202-4345
    cellular: 904-237-7253
    Business Email-jamie.dugan@bmcjax.com
    cdis.icd10@bmcjax.com
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