ATLANTA, GA USA (UroToday) - This was an insightful and productive discussion on the use of nurse practitioners (NPs) and physician assistants (PAs) in urology, and their expanding roles.
Mary Mathe, a physician assistant in private practice in Florida provided an overview of the education and training process for NPs and PAs, noting some of the differences in their certification process. Alan Wein, chief of urology at the University of Pennsylvania, presented data about the number of urologists in the US and the geographic distribution (e.g. rural vs. urban). Dr. Wein proposed gaps in practice that may occur related to the shortage. He also presented arguments against the use of NPs and PAs. But what was clear in this debate is that NPs and PAs are expanding their roles in urology and a growing body of literature highlights those changes.
[refs: Quallich SA. A survey evaluating the current role of the nurse practitioner in urology. Urol Nurs. 2011 Nov-Dec;31(6):328, 330-6. PMID: 22263440
Schultz H. Practical and legal implications of nurse practitioners and physician assistants in cystoscopy. Urol Nurs. 2011 Nov-Dec;31(6):355-8. PMID: 22263444
Turner B, Aslet P. Nurse practitioner-led prostate biopsy in the United Kingdom. Urol Nurs. 2011 Nov-Dec;31(6):351-3. PMID: 22263443]
Dr. Wein presented the results of an online survey, conducted by UroToday, of practicing urologists (n=527) in the US. Two hundred fifty-five indicated that they employ > 1 NP or PA and 134 (52.5%) use them to perform cystoscopy (diagnostic, stent removal), but mainly under their direct supervision (85%). A lesser number (n=49, 19.2%) use their NP and/or PA to perform prostate needle biopsies, all under direct supervision. Dr. Kogan asked both speakers if PAs/NPs, in their practices, will be doing procedures such as cystoscopy. Ms. Mathe felt this expansion would occur in her practice and felt in general that NP/PA role expansion will continue. Dr Wein felt that it would not occur in his practice because residents are available. He felt that any role expansion should be under supervision of the urologist, noting that the definition of supervision needs to be clarified.
Presented by Barry Kogan, MD, Alan Wein, MD, and Mary Mathe, PA-C at the American Urological Association (AUA) Annual Meeting - May 19 - 23, 2012 - Georgia World Congress Center - Atlanta, GA USA
