title: Changing practice models in otolaryngology-head and neck surgery: the role for collaborative practice.
abstract: The increased complexity of medicine, the imperative of reducing health care costs, and the goals of improving quality and patient satisfaction require that we rethink current models of practice. Such reevaluation will receive additional impetus from workforce changes within medicine and the specialty. Furthermore, as chronic disorder care becomes more complex, it may increasingly be provided within a specialty setting. Our goal is to stimulate discussion regarding the potential for alternative health care delivery models within the specialty in the face of predicted workforce shortages and the impetus toward health care reform. A collaborative practice model utilizing midlevel health care providers increases productivity and patient satisfaction and provides the potential to deliver an exceptionally high level of care for chronic disorders when such care is sufficiently complex to require specialty management.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Reger
authors.forename: David W
authors.initials: DW
authors.lastname: Kennedy
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D003695:Delivery of Health Care; D006801:Humans; D009722:Nurse Practitioners; D010036:Otolaryngology; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D011216:Practice Management, Medical / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care