Embracing a changing workforce: Preparing advanced practice providers for practice is key

Christen Hunt, DNP, FNP-C, CPNP-AC
Vizient Associate Vice President, Workforce Consulting

As leaders in healthcare, we're no strangers to the relentless evolution of our field. One significant shift is the projected continuing change in the ratio of physicians to advanced practice providers (APPs) — nurse practitioners and physician assistants. According to the 2023 Census Bureau report, there were 834,500 physician jobs and 503,000 APP jobs, averaging 1.66 physicians per APP. By 2033, projections show there will be 869,000 physician jobs and a substantial rise in APP jobs to 687,900, shifting the ratio to just 1.26 physicians per APP.

This impending change underscores the importance of acknowledging the role of APPs in healthcare and the importance of preparing them for practice. Just like physicians, APPs graduate with baseline clinical knowledge. However, the support provided to them as they transition into practice often does not measure up to what their physician colleagues receive, even as expectations for APPs' performance continue to rise.

Making the case

Historically, physicians employed APPs and had a vested interest in properly onboarding and supporting them as they transitioned into their roles. However, as the number of APPs grows, more APPs are being hired by health systems, shifting the onboarding and transitioning to practice responsibility to the healthcare system, which often is lacking. Without a robust transition-to-practice program, APPs are setup to fail. And it's not just the APP who suffers. The ripple effect reaches the organization and, most importantly, the patients we serve. As the provider mix continues to evolve, organizations must proactively adapt to support the changing workforce.

The learning curve for APPs transitioning into practice is steep. Navigating complex patient populations, intricate healthcare systems and the gamut of clinical scenarios requires more than just baseline clinical knowledge. It calls for experience, mentorship and a supportive environment that fosters rapid learning and growth.

Physicians have long recognized this need. Residency programs provide newly graduated physicians with the space and structure to hone their skills, gain experience and transition from student to practitioner smoothly.

APPs also need the same structured support system. They are expected to perform at high levels soon after graduation, often without adequate support or transitional training. This expectation is not only unrealistic but also detrimental. It places undue stress on APPs, potentially leading to burnout, high turnover rates and, unfortunately, suboptimal patient outcomes.

Call to action

Healthcare leaders must urgently act to address this gap. Implementing comprehensive APP transition-to-practice programs is one critical step toward this goal. Such programs can provide APPs with the support, mentorship and structured environment they need to succeed. Key components include:

• Organizational enculturation: Ensure that APPs have a clear understanding of the organization's mission, vision and goals. This helps them see how their work directly impacts the organization's objectives.
• Confidence building: The transition period can be challenging for new APPs. A structured program can help them build confidence in their clinical skills and knowledge, empowering them to provide high-quality care.
• Early leadership development: Equip APPs with the necessary knowledge and skills to effectively lead care teams. This prepares them for future leadership roles within the organization.
• Interprofessional collaboration: Create a supportive environment for new APPs to integrate into the clinical team and foster relationships with their colleagues across the healthcare system. Collaboration enhances patient care and improves the overall culture.

The benefits of these programs extend beyond the individual APP. They can enhance patient care quality, increase provider satisfaction, improve culture and reduce turnover. The integration of these programs establishes a seamless system approach to supporting APPs that is repeatable. Moreover, they prepare our organizations for the future. As the provider mix continues to shift with growing APPs, these programs will ensure we have a competent, confident and efficient workforce ready to meet the complex healthcare needs of our patients.

The evolving landscape of healthcare demands that we revisit how we support our providers. The projected shift in provider mix is a call to action for healthcare organizations. We must invest in comprehensive APP transition-to-practice programs, ensuring that all our providers have the support they need to deliver the highest level of care. The future of healthcare depends on our ability to adapt and prepare for these changes. Let us embrace this challenge and lead our organizations into a future where all providers are set up for success.

Learn about Vizient's Advanced Practice Advising and Transition to Practice capabilities.