Can Advanced Practice Providers Fill the Hole in Anal Dysplasia Care?

Abstract

Background: The need for anal dysplasia care is beyond what current providers can manage. A gap exists between the overwhelming number of patients needing care and the number of medical professionals providing appropriate care. Advanced practice providers (APPs) including Nurse Practitioners (NPs) and PAs are licensed medical professionals known to expand access to care in certain settings, and potential key players in expansion of anal dysplasia care. Methods: Review of APP 1) education and training 2) State, federal, and national policy 3) Literature pertaining to APP practice and public opinion.The authors will explore differences in NP and PA education, training, practice, and policy as they relate to anal dysplasia care. Results: NPs and PAs have provided health care collaboratively across specialties in the US since 1971. APPs undergo state licensure and national board certification. APPs have prescribing privileges in all states and ability to perform invasive procedures with proper education, training, and experience.PAs are trained in the medical model. PA Optimal Team Practice policy has led to expansion of the roles of PAs and has lead to progressive changes in legislation increasing the ability of PAs to provide care in multiple setting. Research shows PAs provide quality care, are trusted providers, and are believed to increase access to care.Educational preparation beyond the Registered Nurse level, is moving from the Masters to Doctoral level. The wholistic, biopsychosocial approach of NPs to assessments and interventions (including teaching patients regarding HPV and its consequences) prepares NPs to initiate, staff, and direct anal dysplasia diagnosis and treatment programs. Conclusions: Education, training, expanding policy, and a positive public opinion of APPs put them in an ideal position to expand access for emerging health care needs including anal dysplasia care.