From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.
Plast Reconstr Surg. 2021 May 1;147(5):862e-871e. doi: 10.1097/PRS.0000000000007877.
The aims of this article are to examine the scope of practice differences between physician assistant and nurse practitioner providers, to identify financial cost and benefits, and to posit the impact of physician extenders on plastic surgery practices.
A review of the literature was performed using the PubMed database. Key words included "plastic surgery AND physician extender AND cost," "plastic surgery AND physician assistant AND cost," and "plastic surgery AND nurse practitioner AND cost." Secondarily, a search was performed for plastic surgery-related specialties of maxillofacial surgery, orthopedic surgery, and otolaryngology. Inclusion criteria consisted of any study design measuring the financial benefits associated with integrating physician extenders.
The PubMed search yielded 91 articles. Eight articles were ultimately included, of which four (plastic, maxillofacial, and orthopedic) discussed the impact of physician assistants and four (orthopedic and otolaryngology) discussed the impact of nurse practitioners. All eight studies demonstrated that integration of physician assistants and nurse practitioners into practices was associated with a net financial gain even after taking into account their overall costs, along with other outcomes such as productivity or time involvement.
As the number of physician extenders continues to grow, especially in subspecialties, plastic surgeons should be aware of their roles and the potentially positive impact of these providers, their respective training, and their quantifiable financial impact toward a plastic surgery practice. Both physician assistants and nurse practitioners appear to have a positive effect on costs in plastic surgery and plastic surgery-related practices.
本文旨在探讨医师助理和执业护师之间的执业范围差异，分析其经济成本和效益，并探讨这些医疗助手对整形手术实践的影响。
通过 PubMed 数据库对文献进行回顾，关键词包括“整形手术 AND 医师助手 AND 成本”“整形手术 AND 医师助理 AND 成本”和“整形手术 AND 执业护师 AND 成本”。其次，对颌面外科、骨科和耳鼻喉科的相关整形手术专业进行了搜索。纳入标准为任何研究设计，旨在衡量与整合医师助手相关的经济利益。
PubMed 搜索结果为 91 篇文章，最终纳入 8 篇文章，其中 4 篇（整形、颌面和骨科）讨论了医师助理的影响，4 篇（骨科和耳鼻喉科）讨论了执业护师的影响。所有 8 项研究均表明，即使考虑到其总成本以及生产力或时间投入等其他结果，将医师助理和执业护师整合到实践中也与净财务收益相关。
随着医师助手数量的不断增加，特别是在亚专业领域，整形医师应该了解他们的角色以及这些提供者可能带来的积极影响、他们各自的培训以及对整形手术实践的可量化经济影响。医师助理和执业护师似乎都对整形手术和相关实践的成本有积极影响。
