TRIAGE PATIENTS TO THE RIGHT CLINICIAN

Many practices use nurse practitioners or other non-physician clinicians (NPCs) as an “overflow valve,” scheduling patients with them only when the patient’s physician is not available. This approach can improperly match patient problems to the clinician whose skills are best suited to take care of them, which can become a patient safety issue. In a perfect scenario, patients whose problems can be capably handled by the training level of an NPC should be prioritized to them, and patients with problems requiring a higher level of training should be prioritized to a physician.

To improve my practice’s ability to effectively utilize NPCs and ease patient anxiety about not seeing “their doctor,” I use three strategies:

1. Education. I consistently teach patients and staff about training differences between physicians and NPCs and the importance of proper visit pairing.

2. Brief huddles during the day. My nurse practitioner and I check in with each other to compare schedules, swap patients as needed, and provide feedback to the front desk.

3. Open door policy. My nurse practitioner knows she can involve me if she ever feels that a problem is beyond her scope. She can simply make a warm handoff to me. This happens often enough that my patients understand that our clinical partnership allows us to offer the most efficient care to them and their families.