Chapter 41 - Conversations toward cohesive practice - Optimizing the emergency physician and APP interface

The variety of practice models in the United States emergency healthcare system is numerous and most of them involve both physicians as well as advanced practice providers (physician assistants and nurse practitioners). Yet, the preparation for how to supervise an APP from a physician perspective, or what to expect from a physician colleague from the APP perspective is not standardized. In this chapter, we sit down with Dr. Eric Boie who is the current medical director for the APP practice at Mayo Clinic in Rochester, Minnesota, as well as Mr. Jeff Wood, PA-C who has been the supervisor of the APPs both in our health system as well in Rochester for nearly a decade until just recently - to discuss our current model of practice, how it supports resident education, how to support APPs autonomy and optimize patient care, how to handle when things don't go as planned and more. 

 

CONTACTS

X - @AlwaysOnEM; @VenkBellamkonda

YouTube - @AlwaysOnEM; @VenkBellamkonda

Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch

Email - [email protected]

 

RELATED READING

• Clark A, Amanti C, Sheng AY. Supervision of Advanced Practice Providers. Emerg Med Clin North Am. 2020 May;38(2):353-361. doi: 10.1016/j.emc.2020.02.007. PMID: 32336330.
• Rainer R, Bambach K. Navigating Supervision of Advanced Practice Providers. Emerg Med Clin North Am. 2025 Feb;43(1):131-138. doi: 10.1016/j.emc.2024.05.030. Epub 2024 Aug 1. PMID: 39515936.
• Lowery B, Scott E, Swanson M. Nurse practitioner perceptions of the impact of physician oversight on quality and safety of nurse practitioner practice. J Am Assoc Nurse Pract. 2016 Aug;28(8):436-45. doi: 10.1002/2327-6924.12336. Epub 2015 Dec 29. PMID: 26712306.
• Haslam-Larmer L, Krassikova A, Wojtowicz E, Vellani S, Feldman S, Katz P, Robert B, Heer C, Martin-Misener R, May K, McGilton KS. Nurse Practitioner and Physician Collaboration in the Long-Term Care Setting: Secondary Analysis of a Scoping Review. J Am Med Dir Assoc. 2025 Feb;26(2):105418. doi: 10.1016/j.jamda.2024.105418. Epub 2024 Dec 27. PMID: 39701552.
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• Guidelines Regarding the Role of Physician Assistants and Nurse Practitioners in the Emergency Department. American College of Emergency Physicians Policy Statement Approved June 2023.