Singh A, Lassner JW, Sleiman MG, Diaz A, Quallich S, Modi PK. Advanced practice providers and wait times in urology offices: a secret shopper study. Urol Pract. 2022;9(5)389-395.

Study Need and Importance

Almost three-quarters of urologists in the United States work directly with an Advanced Practice Provider (APP), such as a nurse practitioner or physician assistant. However, the impact of APPs on improving new patient access is not well understood.

In this study, we examined the impact of APPs on new patient wait times in a real-world sample of urology offices. To simulate a real-world scenario, we used a simulated patient (or “secret-shopper”) methodology to collect data regarding wait times and provider type for new patient office visits.

What We Found

Of 86 urology offices in the Chicago metropolitan area with which we scheduled appointments, 55 (64%) employed at least 1 APP but only 18 (21%) allowed for new patient appointments with APPs. When the earliest appointment regardless of provider type was requested, offices with APPs could offer shorter wait times compared to physician-only offices (10 vs 18 days; p=0.09; see Figure). Offices offering initial appointments with an APP were available with a significantly shorter wait than those with a physician (5 vs 15 days; p=0.04).

Limitations

This study was limited to a chief complaint of gross hematuria, which may not be generalizable to all new patient visits in urology. Further, our study does not address the quality of care or appropriateness of new patient visits with APPs. These issues are essential to further understanding the role of APPs in the urological workforce.

Interpretations for Patient Care

Our results highlight the prevalence of APP employment in urology offices coupled with low use in new patient visits. There may be unrealized opportunities for urologists to improve patient access by offering new patient appointments with APPs.