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THE 2023 OTOLARYNGOLOGY WORKFORCE

Nonacademic Hospital settings. This might be due to increased call burden, higher provider needs, and recruiting problems, as noted in these same practice settings across both the 2022 and 2023 Otolaryngology Workforce Surveys. When it comes to training APPs, most practices use a standard apprenticeship model and on-the-job training (Figure 6.9). Training courses are rarely used, and some APPs come with prior work training. Time to competency seems to be bimodal – physicians are split as to whether competency is achieved at six or twelve months (Figure 6.10). In the end, ongoing performance evaluations and objective skills assessments are important to ensure that APPs and otolaryngologists have the same expectations for success. We, as a specialty, will also have to decide

if these apprenticeship models are ideal, or if a more formal training program is necessary for uniformity.

Finally, while some states allow APPs to practice independently, a minority of groups within the otolaryngology community employ restrictive covenants to retain their APPs (Figure 6.11). With recent rule changes around non-compete clauses, this question may become obsolete in the future. Future considerations in this section could include querying APPs, as we do physicians, and unpacking the economics of APP utilization in the OR. Given the robust APP utilization among our practices, expected growth, and dynamic changes in this market, it will be vital to pay attention to how these questions change over time.

Analysis: Advanced Practice Providers

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AMERICAN ACADEMY OF OTOLARYNGOLOGY–HEAD AND NECK SURGERY

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