[NPInfo] ACC Statement on the use of APC

[David Mittman]

Advanced Practice Clinician: A Term to Describe
the NP and PA Professions


A Position Statement by the American College of Clinicians
Adopted October 2007.
www.amcollege.org

Physician Assistants and Nurse Practitioners, although separate professions,
commonly have been grouped together since the inception of both professions.
As NPs and PAs are employed by the same organizations and possibly because
they both practice clinically in the same way, many organizations have
looked for a label to use to describe both professions. Throughout the
history of both groups the employers, third party payors and the government
have used various terms to group these clinicians. Generally, all of the
terms used were frowned upon by both professions. Over the last thirty
years, phrases such as physician extender, mid-level, non-physician provider
and others have been used to describe PAs and NPs. It seems that over the
last decade the term ³midlevel provider² has emerged as the most commonly
used term, especially on the West Coast, as it is presumed this term
originated at Kaiser Permenente. To date, no name has emerged that is looked
upon favorably by either profession.

The American College of Clinicians was asked by it¹s members to try to
remedy this situation. Although we feel that both professions could and
should be described by the use of their respective professional titles, we
are also forced to recognize that the medical care world has always wanted
an umbrella term to describe both professions. Many of our members felt that
the term ³midlevel² is especially troublesome as it suggests that there are
higher and lower levels of health care. This terminology is disturbing to us
as it is misleading to the public and a significant slight on many other
professions. As nurse practitioners and physician assistants are held to the
same level of care that a physician is, the level of care we provide is
recognized to be at the highest level. There is no ³middle² regarding our
level or quality of care. Also troublesome is the question of who would
constitute the lowest and highest level of healthcare provider, and who
determines these levels?

After much debate and consideration, the American College of Clinicians
endorses the term ³Advanced Practice Clinician² (APC), as the favored term
to describe the nurse practitioner and physician assistant professions. We
encourage researchers, employers, educators, policy makers and others to use
this term to replace ³midlevel² and other common terms that have been
historically used. We felt that although the ³advanced practice² term fits
better for nurse practitioners the inclusion of clinician and the use of the
word advanced best describe the type of practice and quality of care that
both professions strive to provide.

The American College of Clinicians is a professional organization committed
to advocating for and working towards the mutual interests of the PA and NP
professions. We feel that by working together we can best serve our mission
of providing the highest level of healthcare to the citizens of the United
States.