Advanced Practice Providers: PAs, NPs, CRNAs

HSS is dedicated to promoting the role of the advanced practice provider (APP) within the institution as well as among the medical community in New York City and nationally. APP roles include: physician assistants (PAs), nurse practitioners (NPs), nurse anesthetists (CRNAs) and clinical nurse specialists (CNSs). APPs are medical providers who can diagnose, treat and manage the care of patients, order and prescribe medications, and perform or assist in surgical procedures, all in collaboration with physicians and surgeons. APPs play an increasingly visible role in healthcare both at HSS and throughout the United States.

HSS PAs, NPs and CRNAs understand the presurgical, intraoperative, postsurgical and overall health needs of our diverse patient population. They are intimately involved in supporting the safest, highest quality care throughout the patient journey, utilizing evidence-based best practices and personalized treatment.

As of early 2020, there are approximately 254 APPs practicing at HSS:

175 PAs
54 NPs
25 CRNAs

HSS believes in delivering value-based care and the best patient experience by utilizing APPs at the top of their licenses and to the best of their abilities in partnership with physicians and surgeons in medical and surgical practice.

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Center for Advance Practice Nursing

Since 1989, the physician assistants (PAs) at HSS have been involved in all aspects of perioperative inpatient and outpatient management, acting on behalf and under the supervision of their attending physician within their scope of practice and licensure.

The Physician Assistant Department is a leader in provider clinical operations working closely with our medical staff to ensure outstanding patient care and a supportive environment for our academic mission. PAs exemplify the concept of collaborative, interdisciplinary care acting, under the guidance of their supervising physicians and in conjunction with all disciplines that support the medical team.

PAs are board certified and licensed to provide medical and surgical care as an integral part of the orthopedic surgical team, which is composed of surgeons, fellows and residents. PA responsibilities include, but are not limited to, serving as the first assistant to the surgeon in the operating room, performing patient examinations, making daily rounds, diagnosing conditions, interpreting labs and studies, and ordering or prescribing medical interventions. PAs can be found in a variety of settings and specialties or subspecialties including:

Anesthesia (PACU/OSCU/SDU)
Medicine/Rheumatology
Pain Management
Private Physician Offices
Radiology
Orthopedic Surgery
- Adult Reconstruction and Joint Replacement (ARJR)
- Spine
- Sports Medicine/Shoulder
- Trauma
- Foot/Ankle
- Hand
- Limb Lengthening and Complex Reconstruction
  Pediatrics

Education and Training

All PAs undergo rigorous training in the medical education model. Most PA programs require the same prerequisite courses as medical school, requiring students to have about three (3) years of healthcare training and experience, culminating in a master’s degree. All PAs are required to receive training in surgery. As delegated by their supervising physician, PAs can practice autonomously or in a collaborative relationship with other members of the healthcare team.

HSS PAs maintain PA licenses in the state in which they practice (New York, New Jersey, or Connecticut), their national board certification, and are credentialed and privileged to practice at the institution.

Services

PAs are at the center of provider-delivered care.

At HSS, PAs:

Obtain health histories and conduct physical exams
Diagnose and treat medical problems
Perform surgery, acting as a first or second assistant for the surgeon
Perform surgical procedures (eg, applying stitches, placing a chest tube, etc)
Prescribe medications and other treatments (eg, physical therapy)
Order and interpret diagnostic (eg, X-rays) and laboratory tests
Educate and counsel patients and caregivers
Manage patients’ overall pre- and postoperative care
Work collaboratively with specialty practice physicians, surgeons and NPs
Provide care for patients in specialty services (acute and critical care settings; ambulatory settings and clinics)
Refer patients to other healthcare professionals as needed

Mentoring and Student Clinical Rotations

During student clinical rotations at HSS, physician assistant students receive structured training. Training includes exposure to all PA roles and responsibilities within their scope of practice and specialty.