1. Physician Extenders in Oncology ANCO Annual Meeting 2005 Matthew Sirott MD Sarah Buenviaje ONP

2. NP’s wear many hats Practitioner Procedures Quality Enhancer Emergencies Manager SCUT Worker Project Manager Financial

3. E & M Advantages Can see 18 to 24 patients daily Allows MD to see more new consults Easy New Consults Same level of coding = same collections when MD present in office More time = happier patients Speed New Consults

4. Procedures Bone Marrow Aspirate and Biopsy Abdominal Paracentesis Omaya access – Intrathecal chemoRx administration Hepatic pump access Minor punch biopsy Intralesional chemotherapy

5. Quality Enhancers More time = happier patients Female touch Chemotherapy counseling – formal packet with consent form Second pair of eyes Management Team

6. Emergencies Walk-in Patients Admissions Chemo Suite Reactions Coverage during MD emergency

7. Managers Medical Assistants RN’s Research Interface Overall manager (small office)

8. Project Manager Standardized Protocols Teaching Packets Research CQI Organization and Workflow Compliance Issues

9. SCUT Worker Phone Calls Lab Review Coumadin management Thalomid re-orders Research Flexible – RN, phlebotomy

10. Financial Increased Chemotherapy Treatments Increased E & M, procedures Maintain workflow because of flexibility

11. Potential Disadvantages Expensive employee Cannot take call Must have MD present for full billing capability Increased practice size = increase MD workload Answering NP questions can take time