AUA 2016: Utilization trends of advanced practice providers for office procedural urologic care in the United States from 2003 to 2014

A recent AUA white paper outlined the expanding role of advanced practice providers (NPs and Pas) in urology practices nationwide.  This presentation was on the trends of independently performed urologic procedural care by advanced practice providers over the last decade.  The authors hypothesized that both the percentage of independently performed urologic procedures was increasing. 

From 2003 to 2012 the number of independent advance practice procedures increased from 54,549 to 203,703.  The most common simple procedures being measurements of postvoid residuals, insertion of catheters and performance of uroflow.  In 2003, only 328 cystoscopies were performed independently by APPs, but this increased to 2284 by 2014 representing nearly a 0.3% of all cystoscopies performed nationwide.  The largest increase in complex procedures performed by APPs was cystoscopic stent removals, increasing from 0.05% of all procedures in 2003 to 1.3% in 2014.  The authors concluded correctly that with shortage of urologists, more practices are relying on advanced practice providers to provide care independently and that performed procedures are increasing over time including procedures of moderate complexity.  I agree with the authors that numbers underestimate the total number of procedures performed by APPs, as many were supervised and thus without a CPT modifier.  But this study clearly show the changing roles and responsibilities of advanced practice providers in the urologic setting.  

Presented by: Erickson et 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA

Written by: 

Diane K. Newman, DNP, Adjunct Professor of Urology in Surgery, Research Investigator Senior and Co-Director, Penn Center for Continence and Pelvic Health

University of Pennsylvania, Division of Urology, 3400 Spruce Street, 3rd Floor Perelman Bldg, Philadelphia, PA. 19104