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Provider Practice Models in Ambulatory Oncology Practice: Analysis of Productivity, Revenue, and Provider and Patient Satisfaction

Departments of Nursing and Medical Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA

Corresponding author: Lawrence N. Shulman, MD, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115; e-mail: Lawrence_Shulman{at}dfci.harvard.edu.

Introduction: Physicians, nurse practitioners (NPs), and physician assistants (PAs) frequently work as collaborative teams in oncology, and the models of practice vary. Optimizing the models for quality of care, provider and patient satisfaction, productivity, and revenue will be critical in the years to come, as stresses on the oncology workforce increase.

Methods: Teams of physicians, NPs, and PAs at the Dana-Farber Cancer Institute (Boston, MA) were studied with regard to practice models and their effects on productivity, visit fees, and provider and patient satisfaction.

Results: Three practice models were identified, dependent on the degree to which providers saw patients together with team members or independently. Overall productivity and visit fees were similar in the three models. In addition, provider and patient satisfaction levels were high in all models.

Conclusions: Varying models of practice among physicians, NPs, and PAs lead to relatively similar levels of productivity and fees as well as provider and patient satisfaction. It is paramount that in the years to come—as the demand for oncology services increases more rapidly than the number of providers—provider teams develop new strategies and care models with even broader participation by other members of the health care system to work more efficiently.

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