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Advanced practice Clinicians in Neurology

Many thanks to Rhonda Finnie, DNP, APRN (and a lot of other acronyms due to her many certifications!) for joining me today on "The Art of Medicine with Dr. Andrew Wilner" to examine the role of nurse practitioners and other nonphysician providers in the health care team.

We discussed the recent article published in JAMA Neurology by Calli Cook, DNP, and Heidi Schwarz, MD, that called attention to the role of advanced practice clinicians (APCs) in neurology (1). Rhonda’s clinical focus for more than 15 years has been neurology and neurosurgery. Currently, she works as a nurse with a 5-member neurosurgical group where she evaluates and cares for patients in the emergency room and intensive care unit. Her clinical activities allow the neurosurgeons to spend more time in the operating room employing their unique skills.

Advanced practice clinicians are a growing part of the healthcare workforce. For example, of the 36,000 members of the American Academy of Neurology, more than 1,600 are APCs. How these providers integrate into patient care with respect to autonomy and scope of practice is very much a work in progress. The inclusion of “midlevels” has not been without its growing pains. Rhonda clarified how the addition of APCs to the healthcare team can benefit patients.

Rhonda explained that postgraduate education such as specialty boards can help APCs prepare for roles in neurology. Mastering the neurologic clinical examination is another key to success.

Physicians and organizations that employ APCs need to have appropriate expectations. Rhonda emphasized that APCs are “not there to replace the physician.” Physicians shouldn’t feel threatened by the integration of APCs into the healthcare team.

Please enjoy this 20-minute interview. Your feedback is always welcome.


Cook CL, Schwarz HB. Advanced Practice Clinicians-Neurology’s Underused Resource, JAMA Neurology, May 24, 2021, doi:10.1001/jamaneurol.2021.1416.

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