Aug. 19, 2025
Advanced practice professionals (APPs) play a critical and growing role in otolaryngology care. When provided with comprehensive onboarding and ongoing support, an APP can serve as an extension of the otolaryngology care team, allowing the practice to expand in scope and volume.
"A physician-APP team approach can provide a more holistic approach to care," says Mary E. Tatum, APRN, the team lead for the Otolaryngology APP group at Mayo Clinic in Jacksonville, Florida. "APPs trained to their top level of practice increase the number of high-functioning healthcare professionals in an ENT practice."
Benefits of adding an APP to your otolaryngology practice
APPs can positively impact a practice's quality by increasing accessibility to seamless, attentive care. They build strong patient relationships and serve as consistent touchpoints throughout a patient's surgical journey. "The contribution of APPs further elevates the standard of service excellence and overall patient satisfaction," says Tatum.
Partnership with an APP also benefits otolaryngologists directly in several ways, including:
- Time. Physicians can significantly off-load their clinic supportive tasks by practicing with an APP, leaving more time to pursue other endeavors such as research, speaking engagements and educational opportunities.
- Volume. A practice's patient load can increase when APPs see patients.
- Revenue. A higher volume of patients and more-efficient care lead to increased revenue for the practice.
- Clinical presence. An APP can maintain a responsive presence by managing patients' questions and urgent needs in the physician's absence.
"Adding an APP allows surgeons to focus on complex procedures and decision-making," says Tatum. "Our ability to independently manage straightforward cases allows surgical practices to accommodate more patients without compromising quality."
Specific ways an APP can be incorporated into an otolaryngology practice include:
- Carrying out the surgical and nonsurgical management of otolaryngological disorders, including rehabilitation and appropriate referrals.
- Conducting diagnostic evaluations of patients with otolaryngological disorders.
- Triaging, evaluating, and managing ear, nose and throat problems and serving as an independent first assistant in the operating room.
- Coordinating multidisciplinary care with oncology, speech therapy and radiation.
- Participating in discharge planning and patient education to reduce length of stay and avoid unnecessary delays to care.
- Performing postoperative tasks, such as nasal debridement and nondissolvable packing removal.
- Managing ongoing survivorship visits and surveillance protocols to enhance long-term follow-up consistency.
Guidance for onboarding and training otolaryngology advanced practice professionals
Many new APPs do not have prior experience with otolaryngology. The American Academy of Otolaryngology — Head and Neck Surgery reports that approximately 75% of otolaryngology APPs are trained within the practice.
Tatum says the role of comprehensive training and orientation when incorporating an APP into a specialized practice cannot be understated. "The goal is for the APP to become an extension of the otolaryngologist, but you need a clearly outlined path to get there," says Tatum. "Putting time into APP onboarding and creating a thorough orientation process will pay off later and create a solid partnership."
Tatum says a comprehensive onboarding process can take 6 to 8 weeks and should include:
- Well-planned orientation. Each week of orientation should focus on a different aspect of the clinical care provided in that practice.
- Subspecialized training if applicable. Identify if the practice wants APPs to subspecialize in areas such as sinus and allergy, facial plastics, and head and neck cancer, among others, or if they should instead work within the entire breadth of otolaryngology.
- Full-time shadowing. During the orientation period, the APPs should not have their own clinic but should be with the physician full time. They should greet patients and conduct appointments as a unit, so they can observe how the physician approaches clinical care.
- Time for supplemental learning. APPs need to process a lot of information during the orientation period. Giving them time each day to review what they learn and look up cases reinforces their knowledge.
- Performing reps with guidance. When teaching otolaryngology procedures, such as diagnostic evaluations or standard interventions, Tatum likes the "watch one, do one, teach one" method. Performing these procedures under supervision gives the APP and the physician confidence that the procedures are being performed correctly.
- Patient interaction strategies. Make sure to discuss strategies for handling patients who may be scared, defiant or angry. Strategies include how to manage patient expectations and channel patient concerns.
- Billing and coding. Include coding sessions to ensure the APP knows the proper levels of coding and how to complete appropriate supporting documentation.
"A comprehensive onboarding process will leave the APPs feeling empowered by the tools and techniques they learn, " says Tatum. "They'll feel invested and like part of the team, making them more likely to stay with the practice long-term."
Fostering a successful physician-APP partnership
When physicians put time and effort into APP onboarding, the practice benefits from having a well-trained and independent nurse practitioner (NP) or physician assistant (PA). The process also helps establish a strong physician-APP relationship. However, providing ongoing support and maintaining open communication is critical for retaining otolaryngology APPs in the long term.
One way to incentivize APPs is to pay for education and licensure. Tatum says that providing paid time to pursue continuing education and growth is not required but is highly recommended. Covering the cost of national credentialing and state licensing is another significant benefit for most APPs.
"Physicians are often amazed by the partnership they develop with NPs and PAs," says Tatum. "Empowering them to help manage the practice independently can significantly reduce the load on the physician and support practice growth while also improving patient satisfaction and access to care. The investment is well worth the outcome."
For more information
American Academy of Otolaryngology — Head and Neck Surgery
Refer a patient to Mayo Clinic.