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Ten reasons to hire an OPA in 2013
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As we enter into the first quarter of 2013, the buzzwords of cost-containment and improved productivity continue to be at the forefront of orthopedics. Practices continue to look for ways to maximize reimbursement, while balancing staffing concerns to maintain adequate productivity and improve upon patient satisfaction.
As I have presented before, employing a physician extender can, in many cases, benefit an orthopedic practice in this regard. There are many different credentialed providers — orthopedic physician’s assistants (OPA-C); advanced registered nurse practitioner; physician’s assistant, certified; athletic trainer, certified; registered nurses; etc.) who work with orthopedic surgeons, and each has a different set of strengths and skills. Any of these providers can be a great addition to an orthopedic practice based on the needs and structure of a given practice, but the focus of this article is on the OPA-C.
Some assume that the OPA profession is about putting on casts, restocking exam rooms and shuffling patients in and out of clinic. This is not the case. OPAs are often part of the entire patient treatment process, from the minute the patient enters the clinic until post-surgical recovery is complete. Going leaner and doing more with fewer resources appears to be the status of the current health care changes. With this in mind, here are 10 reasons to consider an OPA-C in your practice:
1. OPAs can make a clinic more efficient
It is challenging to predict how long we will spend evaluating and seeing a particular patient. It is often the case that the patient needs more time than we allot. Other patients continue pouring into the waiting room. This is when the wait times start to add up and satisfaction on everyone’s part starts to decline. Employing an OPA allows other patients to be worked up and ready for the surgeon. Waiting time is kept to a minimum.
Jason Mazza
2. Surgeons can spend more time with complex cases
In line with this, the surgeon can spend more time focusing on patients who need it. The OPA can be starting the work-ups and obtaining preliminary information on the other scheduled patients. The OPA can then be ready to present these patients, while allowing the surgeon to focus on one patient at a time.
3. Increased revenues to the practice
As I have presented in a prior article (Real Dollars and Sense: Use of an OPA-C in a clinical practice. Orthopedics Today. 2011 Nov.), an OPA can improve efficiency in clinic by at least 30%. The clinical environment and schedule can be structured in a way that the surgeon can see an extra one patient to two patients (or more) per hour with the assistance of a well-trained OPA. An extra 12 patients to 15 patients per day compounded yearly at the current reimbursement rates for follow-up and new patients can net an additional $150,000 to $200,000 per year. OPAs also are eligible for reimbursement as a first surgical assistant under most private insurances. Based on surgical volume, this can quickly add up. In some clinics, OPAs manage durable medical equipment (DME) and bracing. A well-structured and managed DME program also can net the practice good reimbursement.
4. OPAs are trained in immobilization techniques
Fundamental training in casting, bracing and splinting is a formal part of the OPA training. This is not a skill that is taught at the university-level for any of the other providers. For them, this is usually learned after one is employed in practice or from continuing education seminars. This is one of the skill sets that the OPA profession was founded upon in the 1970s.
5. Well-rounded education in orthopedics
The University of St. Augustine for Health Sciences is the formal training program for OPAs. It is a 2-year master’s program. Students are exposed to all aspects of orthopedics and complete several rotations throughout different orthopedic subspecialties. This type of training model is similar to that of an orthopedic surgeon and allows graduates to enter into practice with a strong fund of orthopedic knowledge and skills. The training of other allied health providers focuses more on a generalist approach. Orthopedics is usually a small part of their curriculum. The benefit to the surgeon is that less time is spent training an OPA on the fundamentals of orthopedics. The OPA immediately brings value to the practice. As orthopedic surgeon
6. Surgical first assistant
One of the hallmarks of the OPA profession is assisting with surgery. OPAs are usually responsible for positioning the patient, draping, assisting with the exposure, providing hemostasis, retraction, assisting with hardware implantation, handling grafts and wound closure. The OPA works with the operating room and anesthesia staff to ensure the patient is receiving the safest and best care possible.
7. Well-trained, knowledgeable clinical assistant
Beyond taking patient histories and assisting with exams, the OPA can provide assistance with electronic medical record (EMR) charting and dictations. Coding of procedures, patient triage, providing clinical support for difficult authorizations and providing hands-on patient care are all part of an OPA’s role in the clinic.
8. Providing patient education and counseling
Patients come to the office armed with information they have gotten from the Internet, various other media sources and friends. They demand time to get answers to their questions and want their problems addressed. This can be a time-consuming venture in some cases. As the OPA is a trained physician extender and works directly with the surgeon, an OPA is taught to think like the supervising surgeon and has adequate knowledge to explain the patient’s condition and treatment and answer many concerns. Under the current health care reform, behavioral counseling including exercise, weight reduction and smoking cessation will need to be addressed with patients by the orthopedic surgeon. This is an area in which the practicing OPA can assist the surgeon and allow for significant time savings.
9. Minimize risk and maintain control of patients
Patients want to see the doctor. This is especially true of our older generation. In one study by Larkin and Hooker published in 2010, nearly 80% of patients expected to see the physician, despite a physician assistant or nurse practitioner also being available in the emergency room setting. Patient satisfaction is largely tied in with this. As the OPA works directly with the surgeon, the surgeon is ultimately seeing each of his or her patients. The surgeon can fully control patient management to his or her own standards and have complete say about the message being delivered. There is little concern about patients’ disconnect resulting from seeing a different practitioner one time, and then the surgeon another. More satisfied patients usually result in fewer professional liability claims. Furthermore, more reviews are being published noting that diagnostic testing is being over used. As practice patterns shift away from ordering tests and spending more time on a patient’s history and physical examination, more of the medical decision making will rest in the hands of surgeons than in those of an allied health practitioner who practices in an autonomous or semi-autonomous role.
10. Comprehensive patient care
OPAs are trained to work in all phases of orthopedic patient care. There is a technical component to the work of OPAs that differs from other providers. As we move towards a system of reimbursement being tied to cost-containment and quality, the OPA is able to fully serve the needs of the surgeon in the clinical, hospital and surgical setting. The other added benefit is that many OPAs also carry additional professional certifications or licensure that allow for expanded duties. This often eliminates the need for other employees in a clinical setting.
OPAs are physician extenders who are trained to work specifically with orthopedic surgeons. In some cases, the OPA works one-on-one with a surgeon or serves as a part of a team to help manage the care of orthopedic patients. In light of the major changes we have seen in health care, we believe that our profession is well positioned to meet the demands of both our aging population and the needs of our surgeons.
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