Know your APPs

There are a few things to keep in mind regarding advanced practice professionals (APP), sometimes known as mid-level practitioners, although this is not their preferred label. According to the International Council of Nurses, an APP can be defined as “a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A master’s degree is recommended for entry level.”

There are several APP positions within the healthcare system, including nurse practitioners (NP), physician assistants (PA), nurse midwives, and nurse anesthetists. Among these exist various distinctions, most notably being independent versus dependent practitioners. The latter are APPs that must be overseen either by a physician or other licensed independent practitioner. Specific supervision requirements are established by state law.

Consider this: PAs are healthcare providers with state authorization to practice medicine as part of a team of physicians. They graduate from an accredited program that is modeled after the medical school curriculum and hold national certification in addition to a state license. NPs, on the other hand, must complete a master’s program that makes them eligible to obtain professional certification, usually focusing on one specialty; this certification must be renewed every five years. Their job duties include assessing patients, ordering and interpreting diagnostic tests, making diagnoses, and initiating and managing treatment plans (including prescribing medication).