Advanced practice providers: a vital part of patient care

Advanced practice provider, or APP, is a comprehensive term for physician assistants, nurse practitioners, certified nurse midwives and certified nurse anesthetists.

APP - Alison MeyerPhysician assistants function in many capacities, whether as a family practice provider, specialist or assisting physicians.

Nurse practitioners have roles similar to physician assistants. The main difference is in education and training. Nurse practitioners typically have a nursing background, while physician assistants have a traditional medical background.

An anesthetist’s primary function is to provide anesthesia in a surgical setting, while midwives offer services in obstetrics.

In Tri-County Health Care’s system, they are a critical part of providing access to health care for patients.


Wearing different hats

At Tri-County’s five rural clinics – Bertha, Henning, Ottertail, Sebeka and Verndale – an APP’s main role is to provide primary care from birth to death, from acute to chronic illnesses.APP - Jill Wilkens

“It’s very similar to what physicians do,” said Alison Meyer, certified nurse practitioner at Bertha Clinic. “Our main focus is doing what’s best for the patient and figuring out how to optimize their quality of life.”

In contrast, Wadena clinic’s APPs aren’t primary providers but rather contribute to a health care team called a pod. These pods include physicians and an APP. If patients are unable to schedule an appointment with their doctor, they can opt to see an APP. As a result, all information and updates on those patients are shared between the physician-APP team.

“I help to maintain a continuity of care,” said Physician Assistant Jill Wilkens, who works in a pod with three doctors. “The patients know and accept me as one of their providers, and if they can’t see their doctor, they want to see me.”

APPs also see walk-in patients in ReadyCare, as well as concentrate on a variety of specialties.

“We’re fortunate that our APPs come from various areas of focus,” said Judy White, vice president of patient care. “They have backgrounds in neurology, pain management, wound care, cardiology, behavioral health, surgery, APP - Norman Hillukkaobstetrics, respiratory therapy and more.”


A patient’s point of view

Menahga resident Norman Hillukka first encountered his APP when he planned to make an appointment with his physician, Heidi Olson, and found that her schedule was full.

Hillukka wasn’t even sure what an APP was when he made the appointment.

“I was a little apprehensive,” he admitted, “but to my surprise, I was truly satisfied. I got everything I needed and I appreciate that if I have a specific problem, I get lots of time and attention from my physician assistant.”

Melissa Morrow of Wadena stresses that it was because of Tina Hulse, certified physician assistant, that she’s here today.

Afflicted by Ehler’s Danlos, a disease that affects connective tissue, Morrow suffered from extreme pain following a hysterectomy on June 20.

Morrow’s husband brought her to the hospital, where Hulse immediately cleared an opening. Hulse discovered that Morrow had bladder retention. Essentially, her bladder had stopped working, urine was building up and her kidneys were shutting down. Hulse removed 2.5 liters of urine from Morrow’s body. Her kidney function returned to normal in less than 24 hours.

“She saved my life,” Morrow said. “She’s amazing.”APP - Tina Hulse

Morrow, who has also received care from other APPs at Tri-County, feels strongly that their role is essential.

“They’re a vital necessity to the medical care that we have nowadays because of the fact that doctors are so hard to get into,” she said. “It’s good to know that there are those medical professionals out there that can do just as much for you as an actual doctor or a specialist.”

Ultimately, the role of an APP comes down to building relationships and reassuring patients that they are in expert hands.

“I think people like to know who they’re seeing and have a connection with them, and we certainly do,” Wilkens said. “We’re very qualified, and we love taking care of you.”

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