The APP-MD Relationship

Erin Darguzas, APN, reviews how physician training culture and expectations are very different from APP training and onboarding and how this can affect expectations and the way APPs are incorporated into IBD practices.

Erin Darguzas, APN, is a nurse practitioner specializing in the care of patients with inflammatory bowel disease at Northwestern Medicine in Chicago, Illinois.

Hi, my name is Erin Darguzas. I am a nurse practitioner at Northwestern Medicine and I had the privilege to help present the APP session at AIBD. This year we had a great turnout with APPs. Coming to this session, my focus was looking at the APP-physician relationship within a practice. And one thing that came from our discussions was that the physician training culture and expectations are very different from the APP's training and onboarding. And that's where in general there's a common standard on how physicians are trained and expectations that they get throughout their training. And it's very methodical. It's a methodical program that's built to have physicians pushed thoroughly and extensively. Their training will include a review of case studies and presentations, journal club procedures, procedural training, surgical training and research. And it was important for apps to hear Dr. Dulai's perspective, and that was the physician who sat with me during this round table discussion, on his training experience and how there could be associations and disconnects on how APPs are then incorporated into practice.

So that was very helpful to review with other APPs, just to get a little bit of how physicians are perceiving our role. And many times APPs are joining a team, and that's very different from when a physician's training background comes into play. However, as we discussed Dr. Dulai’s training experience, it became very clear that most APPs don't receive a formal training into their practice. Physicians know the expectations and requirements to train other physicians, but with APPs, the role is different and physicians may utilize APPs in their practice a little differently, whether it's an independent provider in clinic or in a hospital setting, or they may have an APP work within their clinics with them in conjunction. So this could impact how APPs are actually trained from the get-go.

And to help bridge this gap, we discuss the importance of incorporating, maybe trying a journal club in your team, and you being the APP, trying to run these journal clubs or present a case study or start to incorporate maybe research interest into your practice. Finally, it was helpful to acknowledge that although APPs do not complete a fellowship or a specific IBD program, majority of these APPs that attended the conference conveyed that IBD is their chosen career. They're committed, they're wanting to know how to manage patients long-term in this field. They want to build, they want to contribute. And you could tell by the excitement and the motivation of these attendees that they really want to make a stamp in the IBD world.