Sentara Medical Group to double number of advanced practice providers, increasing access

Sentara Medical Group plans to double its number of advanced practice providers in the next three years as part of a new, team-based approach to primary care.

The initiative will give patients better access to primary care providers amid an ongoing national physician shortage, said Dr. Steven Pearman, Sentara’s vice president and chief medical officer for primary care.

“We’re surrounding primary care physicians with a team of advanced practice providers, nurses, pharmacists, and virtual care team members so that Sentara and Sentara Medical Group can provide better access to patients,” said Dr. Pearman.

“Each advanced practice provider added to a physician-led team increases primary care capacity by over 70%.”

Advanced practice provider is a term for a healthcare professional with an advanced degree who can perform many of the medical activities performed by physicians, including conducting physical exams, prescribing medications, and making referrals.

Most commonly the term refers to a nurse practitioner or physician assistant. It can also mean a clinical nurse specialist, certified registered nurse anesthetist, or certified nurse midwife.

In addition to increasing the number of advanced practice providers, the new, team-based model shifts administrative duties away from providers, such as physicians and advanced practice providers. Those duties will now be handled by medical assistants, clinical pharmacists, and others.

“We’re giving our providers more time to take care of you and enabling them to spend less time on things that other people can do,” Dr. Pearman said.

A growing segment of the healthcare workforce

Advanced practice providers are expected to be among the fastest growing segments of the healthcare workforce in the coming years.

In the next decade, nurse practitioners and physician assistants will be among the top 10 fastest growing occupations in the country, according to the by the U.S. Bureau of Labor Statistics.

In contrast, physician jobs are projected to grow at an average rate, leaving a national shortage of 13,500 to 86,000 physicians by 2036.

As part of efforts to optimize the use of advanced practice providers, Sentara has recently established new leadership positions dedicated to supporting this workforce.

Todd Roark, a nurse practitioner who previously served in a leadership role at Michigan’s Henry Ford Health, one of the nation’s leading health systems, started as vice president of advanced practice professionals at Sentara in August.

“We have to get creative to address growing consumer needs,” said Roark. “And that means leveraging our medical professionals so they can practice to the full extent of their training and capabilities.”

Advanced practice providers can manage a large majority of healthcare needs, he added.

Regulations for advanced practice providers vary across states. In Virginia, advanced practice providers can perform 80 to 90 percent of the activities that a doctor can perform, according to Dr. Pearman.

Receiving care from advanced practice providers

Across the country, many patients already see advanced practice providers for primary and specialty care. In 2019, researchers found that nurse practitioners and physician assistants accounted for more than a quarter of healthcare visits in the U.S.

Research has shown that many patients view these providers positively.

A 2020 study found that nurse practitioners in specialty settings performed as well as physicians in terms of clinical safety and exceeded them in patient satisfaction.

A 2023 survey found that Americans believe physician assistants add value to healthcare teams and are part of the solution to address the shortage of providers.

“There’s a little bit of hesitancy for some people,” said Dr. Pearman. “But most people who have advanced practice providers as their primary care provider are really happy with them.”

After their primary care physician passed away, husband and wife Brian Greenlaw Sr. and Nancy Greenlaw began seeing physician assistants at Sentara Medical Group practices near their home.

“They can do the same thing a doctor does,” said Brian after a recent visit to the practice.

“And their bedside manner is a positive, a very big positive,” said Nancy.

“The care we’re getting from the physician assistants is great,” added Brian.  

Rolling out the new model

Under Sentara’s new, collaborative model, providers will share a group of patients, increasing access.

“The general concept is to pair one physician with two advanced practice providers,” said Stephanie Zeiber, a physician assistant and one of Sentara’s two newly appointed directors of advance practice provider development.

"Patients may have their primary go-to within that care team, but all of the team members would be working together to meet the needs of patients.”

Stephanie Zeiber, a physician assistant and a newly appointed director of advance practice provider development, meets with Brian Greenlaw Sr. and Nancy Greenlaw at a Sentara Family Medicine practice in Virginia Beach, Va.

Sentara is working with academic institutions to increase recruitment of advanced practice providers, including the newly launched Macon & Joan Brock Virginia Health Sciences at Old Dominion University, which hosts both nurse practitioner and physician assistant programs, said Zeiber.

Sentara has also created a new onboarding process and mentorship program.

“Access is a huge issue,” said Zeiber. “It can take anywhere from six to 12 months to see a primary care provider. Opening more positions for advanced practice providers should reduce wait times and give patients the care they deserve.”