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in need of physician extenders (regardless of whether they currently
employ them). A slight majority of respondents, 53 percent,
said that their practices are in need of physician extender assistance
compared with 47 percent who did not.
Survey respondents who currently employ physician extenders
were asked how they are using PEs, and those not currently
employing PEs were asked how their practices would like to use
them. Respondents could check any option that applied (multiple
options).
Most respondents identified “hospital based patient evaluation
and management” (74 percent) and “office patient evaluation and
management” (73 percent) as among the duties for physician extenders.
The selection “phone call returns/administrative duties (letters
of appeals)” generated 70 percent of responses, and 64 percent
selected “first assist in the operating room.”When asked specifically
about which invasive procedures they would like physician extenders
to perform, top choices were suturing (58 percent) and lumbar
punctures (36 percent).
The pie chart on page 26 illustrates reasons for employing physician
extenders. As shown, most respondents selected to “increase
patient volume in the office” (74 percent) and to “assist in the operating
room” (70 percent).
Long range plans under consideration
include developing a physician
extender curriculum for competency
in neurosurgery, developing advanced
curriculum for continued education,
and investigating Web-based modules
for a formal training program.
Neurosurgical Training for Physician Extenders
The majority of respondents, 81 percent, indicated that “on the job
training” best describes the method of physician extenders’ neurosurgical
training. Sixteen percent reported that extenders were
trained in a formal training program. Only 2 percent indicated they
were trained in the military. The majority of respondents (60 percent)
also indicated that their physician extenders received training
at a university hospital.
When asked how long the neurosurgical training period was,
the majority of respondents, 57 percent, indicated that their physician
extenders received training for six months or less and 21 percent
indicated one year.
More than 77 percent of respondents reported that the establishment
of formal training programs for physician extenders in neurosurgery
would be useful. When asked how long this training period
should be to gain competence in the tasks that neurosurgeons expect
a physician extender to accomplish, over half, 52 percent, selected six
months of neurosurgical training. Thirty-seven percent selected one
year. The participants were equally divided on who should be paying
for the training: 40 percent said the physician extender, and 40 percent
said the future or current employer. About 57 percent indicated
that they expect the physician extender to receive a salary while
attending an extended training program in neurosurgery.
Working With the AANS
When asked: “which of the following AANS offerings would best
help meet the educational needs of physician extenders,” 62 percent
selected “AANS annual meeting practical clinics or breakfast seminars.”
Fifty-three percent of respondents selected “AANS instructional
DVDs, publications or online offerings,” and 36 percent
selected the “AANS Master Series courses taught in educational/
research facilities offering lab work using cadaver material.” (Multiple
selections were allowed.)
“Survey participants also identified many topics and types of
educational experiences they would like extenders to receive from
the AANS,” said Dr. Hodge. “Leadership reviewed a summary of
write-in recommendations.”
Moving Forward
With survey results in hand as well as input from the task force, the
Long Range Planning Committee began to address the issue of
using of physician extenders as one of many solutions to workforce
shortages.
“Initially, training courses for physician extenders will be offered
during the 2006 AANS Annual Meeting in San Francisco,” said Dr.
Hodge. “Short-range plans focus on identifying funding for additional
physician extender neurosurgical training and expanding
AANS offerings for physician extenders. Long range plans under
consideration include developing a physician extender curriculum
for competency in neurosurgery, developing advanced curriculum
for continued education, and investigating Web-based modules for
a formal training program.”
Addressing workforce issues has been a priority for Dr. Wirth
during his presidential year.
“It is clear that there is tremendous potential for physician
extenders to help alleviate neurosurgical workforce shortages,” said
Dr. Wirth.“We are considering all the recommendations of the task
force and are working closely with nurse practitioner and physician
assistant organizations to investigate which avenues will result in
optimal benefit to our patients.” 3
Kathleen T. Craig is AANS director of marketing.
Volume 14, Number 4 • AANS Bulletin 27