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Advanced Practice Provider FAQ

What is an APP?

Advanced practice provider, or APP, is a comprehensive term for physician assistants, nurse practitioners, certified nurse midwives and certified registered nurse anesthetists. PAs and NPs typically work under the supervision of a physician and are certified to perform much of the same care as a physician, while CNMs and CRNAs have more specific areas of care.

At Tri-County Health Care, APPs function in different capacities based on where they are located:

Wadena Clinic: APPs work in a pod system that can include an APP and multiple doctors. In this model, APPs help to maintain a physician’s practice, as well as the continuity of care. If a physician’s schedule will not allow an immediate appointment, APPs typically have more flexible schedules. Because they can perform most of what a physician can, the continuity of the patient’s care is maintained and shared between the team.

Rural Clinics: At TCHC’s six rural clinics – Baxter, Bertha, Henning, Ottertail, Sebeka and Verndale –APPs function independently as primary providers. Their practice involves patients of all ages, from birth to death, and all illnesses, whether acute or chronic. If need be, they also have the opportunity to consult with visiting physicians.

Specialty Care: APPs can specialize in nearly any area – such as women’s health, orthopedics, wound care, gerontology and behavioral health – and work either independently or in collaboration with other physicians in their chosen specialty.

ReadyCare: Tri-County Health Care’s walk-in clinic offers same-day appointments for conditions such as sprains, stomach flus, ear aches, pink eye, minor trauma, fever and more. APPs who work in the ReadyCare setting operate as independent providers.

What is the difference between the APP designations?

Physician Assistant (PA)

A PA is a licensed health care provider who provides primary, acute and specialty health care, which are services traditionally performed by a physician. This includes conducting physical exams, ordering tests, prescribing medications, diagnosing and treating illnesses, assisting in surgery, developing treatment plans and more. Teamwork is at the core of a PA’s training, giving them the qualifications needed to work independently or in a collaborative health care team. A PA can specialize in nearly any field.

Education: PA programs require the same prerequisites as medical school and require students to have three years of health care training and experience. They must complete more than 2,000 hours of clinical rotations. Before PAs can practice, they must be licensed in the state in which they wish to practice and pass an exam by the National Commission on Certification of Physician Assistants. A PA listed as “PA-C” means that they are currently certified. To remain certified, they must complete a recertification exam every 10 years and complete 100 hours of continuing medical education every two years.

Certified Nurse Practitioner (CNP)

A CNP is an advanced practice registered nurse who provides primary, acute and specialty health care, which are services traditionally performed by a physician. This includes prescribing medication, diagnosing illnesses, ordering and interpreting tests, managing treatment and conducting physical exams. A defining aspect of their care is that they blend diagnosis and treatment with disease prevention and health management, focusing on patient education. CNPs also tend to work more independently and can also pursue extra certification in specialties such as family practice, gerontology, podiatry and psychiatry.

Education: CNPs must first receive a bachelor’s degree in nursing, become a registered nurse, and then complete a master’s or doctorate degree. After that, they must earn advanced practice nursing licensure in practical nursing in their chosen state of practice and undergo national board certification.

Certified Registered Nurse Anesthetist (CRNA)

A CRNA is an advanced practice registered nurse who works with surgeons and anesthesiologists to administer anesthesia to patients. CRNA is the only classification of nurse that is licensed to provide anesthesia services. They practice in any area where anesthesia is needed, such as surgery, emergency departments and obstetrics.

Education: CRNAs must receive a master’s degree from a nurse anesthesia program accredited by the Council on Accreditation of Nurse Anesthesia Education Programs. They must also be licensed as a registered nurse in the U.S. and pass a national certification examination.

Certified Nurse Midwife (CNM)

A CNM is an independent advanced practice registered nurse who provides a full range of primary health care for women from adolescence to beyond menopause with a focus on holistic care, pregnancy and delivery. Their services include well woman exams, parent education, prenatal care, nutrition counseling, and care during pregnancy, childbirth and postpartum.

Education: Many graduate programs require CNMs to first become a registered nurse. Following graduation from a nurse midwifery program accredited by the Accreditation Commission for Midwifery Education, CNMs receive either a master’s or doctorate degree and are then eligible to take a national certification examination through the American Midwifery Certification Board.

Is an APP less qualified than a physician?

An APP goes through extensive medical education that allows them to provide many of the same services as physicians, including primary care, physical exams, ordering tests, prescribing medications, diagnosing and treating illnesses, assisting in surgery, developing treatment plans and more. There are certain duties an APP doesn’t perform, and an APP may also need to consult with a physician if a patient needs a higher level of care such as a specialist. Physicians also tend to put a focus on chronic, complex medical issues.

Why see an APP instead of your physician?

Physicians are in high demand across the U.S., which means that sometimes their schedules don’t always allow for timely appointments. APPs are typically more available, and at Wadena Clinic, they work in a team with physicians, so the line of communication is always open between the two. This forms a reliable health care team for each patient.

What do APPs contribute to health care?

Not only do APPs bring a wealth of knowledge gained from extensive medical education, but they are critical in ensuring health care is available to patients. Due to the shortage of physicians across the U.S. in recent years, as well as pressure to reduce health care costs, the number of APPs and the importance of their role have increased. Studies show that APPs help to increase access to care, improve cost savings, decrease readmission rates and lower the risk of infection.


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