Practice Notes

Hiring an AP leader: 5 must-have characteristics


Kelsey Mahler

Our members continue to tell us that they’re hiring more APs to help manage expanding patient access and improve care value. In fact, Merritt Hawkins recently reported a 320% increase in demand for nurse practitioners over the last three years. 

But the most progressive groups we’ve seen have also created dedicated AP leadership positions to manage this growing AP population.

Why should you hire an AP leader?

ProMedica Physician Group quadrupled their AP workforce over four years in order to meet anticipated access challenges. But group leaders soon realized that the existing management structure for APs was insufficient for this larger cohort, which had grown to include more than 100 APs. Two key challenges included lack of centralized strategic oversight of AP deployment and failure to manage AP clinical use and performance. So leaders created the role of Director of Medical Operations for Advanced Practice Providers to manage their APs.

Tool: Calculate the financial impact of hiring additional APs to your practice

But groups don’t need to wait until their AP cohorts reach triple digits to find value in a dedicated AP manager. When DeKalb Medical Group created an AP leadership position, the group employed only 17 APs. Because the group’s leaders planned to employ many more APs, they wanted to make sure the necessary infrastructure was in place to facilitate that growth. 

As the graphic below illustrates, DeKalb's Director of Advanced Practitioners works closely with medical staff and hospital administrators to expand AP inpatient privileges and structure AP employment.

The AP leader serves as a single point of contact on all issues related to APs. The leader focuses primarily on how to best use and engage APs, and how to develop expertise on issues like AP regulations. In DeKalb’s case, hiring an AP leader early on set the stage for more robust AP utilization.

What should you look for in an AP leader?

Once you decide to hire an AP leader, you need to know what you're looking for. We analyzed six AP leader job descriptions, including DeKalb’s, to distill common attributes that groups are looking for in their AP managers.

Here are five must-have qualities we identified:

Clinical experience. AP leaders should have experience and proven effectiveness as practicing clinicians. Most AP leaders will take active roles in tasks that require clinical knowledge—peer-managing, onboarding, performance management, and continued AP career development. Your group's culture will determine whether you hire a physician or an AP to fill this role, but we've broken down some of the most important considerations to help you make that decision.

Management experience. AP leaders should demonstrate the ability to lead individuals and/or teams across disciplines, and act as peer mentors when appropriate. AP leaders will focus much of their time on AP oversight and performance management. In some groups, AP leaders will need to manage a large group of APs, making management experience an important prerequisite.

Strong facilitation, consensus-building, and negotiation skills. AP leaders should possess a demonstrated ability to work with all levels of staff, including administrators, physicians, and peers. Because they work so closely with both medical staff and hospital administrators, AP leaders need to be able to navigate competing interests while considering the best interests of the group as a whole.

Understanding of broader group goals. AP leaders should understand how APs can contribute to institution-wide initiatives on both the medical group and health system levels. Because AP leaders will represent the AP cohort and serve as a main point of contact for other senior leaders across the group, the AP leader should be prepared to support the development, pursuit, and achievement of organizational goals.

Expertise on practice and regulatory compliance. AP leaders should be experts on AP regulations, such as licensure and scope of practice, to advocate for top-of-license practice for APs. For an overview of state-by-state variations on these rules, take a look at our guide to state regulations.

Tell us where you stand


9 tools your peers developed to maximize APs

We've compiled a toolkit of job descriptions, templates, and worksheets medical group leaders use to hire, train, and evaluate advanced practitioners. Access the toolkit.


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