NP and PA-Led Practices: A Possible Remedy for Health Care Worker Burnout

Annie Depasquale, MD, is a board-certified family medicine physician and founder of Collaborating Docs.

(Image courtesy of Collaborating Docs.)

Burnout among health care workers, including infection prevention, has become a critical issue exacerbated by the COVID-19 pandemic. Nurse practitioners (NPs) and physician assistants (PAs) increasingly turn to independent practices as a solution, offering greater control over their work-life balance, patient care, and overall mental well-being. These NP and PA-led practices are not only easing the burden on traditional health care settings but also improving patient outcomes and helping to maintain infection control standards by alleviating overcrowded facilities and reducing staff burnout.

To learn more, Infection Control Today^® (ICT^®) interviewed Annie DePasqualie, MD, board-certified family medicine physician and founder of Collaborating Docs, a service that has helped over 4000 NPs and PAs match with collaborating physicians.

ICT: Burnout is critical for health care workers, especially infection prevention. How have you seen burnout manifest in your teams, particularly after the COVID-19 pandemic?

Annie DePasquale, MD: Burnout has been a critical issue for health care workers across the board, but we are seeing a unique solution emerge through the rise of NPs and PA-led practices. Many nurse practitioners and physician assistants, overwhelmed by the stress and bureaucracy of traditional health care settings, are choosing to open their practices. This gives them more autonomy over their schedules, workload, and patient care approach—key factors in mitigating burnout.

For many NPs and PAs, opening their practice isn’t just a career pivot; it’s a way to regain control over their work-life balance and mental well-being. By creating patient-centered practices with more flexible hours, personalized care, and smaller patient panels directly address some of the significant contributors to burnout—such as long hours, high patient loads, and limited decision-making power. This model is not only helping providers themselves but is also a powerful solution to the broader burnout issue in health care by easing the strain on overburdened traditional systems.

ICT: NP and PA-led practices are being highlighted as a solution to reduce wait times and ease provider workloads. From your experience, how do these alternative care models help alleviate pressure in infection control settings?

AP: NP and PA-led practices have proven to be game-changers in reducing patient wait times and alleviating provider workloads. These practices improve patient access to care and help mitigate burnout among healthcare workers by distributing the patient load more effectively across the system. While infection control may not be the primary focus in these independent practices, their impact on the broader healthcare system is substantial.

By creating additional points of care, NP and PA-led practices allow patients with nonurgent needs to avoid the often-overburdened hospital and clinic systems. This reduces the overall patient load in more traditional settings, allowing infection control teams and other specialists to focus on the most critical cases. In essence, these alternative care models serve as a pressure valve, helping to reduce overcrowding and the associated risks of infection spread in high-volume environments.

The increased flexibility and autonomy for NPs and PAs in these practices also means they can better manage their health and well-being, directly addressing burnout. It's a win-win—helping patients get timely care and enabling providers to thrive in a more sustainable work environment.

ICT: With flu season approaching, what strategies are in place to manage the increased patient load while ensuring infection prevention standards are upheld, especially given staff shortages or burnout risks?

AP: With flu season approaching, health care facilities are implementing various strategies to manage increased patient loads while upholding infection prevention standards. One key approach is enhancing triage systems to prioritize the most critical cases. This allows hospitals and health care facilities to identify and treat high-risk patients quickly, ensuring that those most need care receive it promptly. With NP and PA-led practices, this is one very effective way to lessen the wait time, helping patient outcomes during critical times.

Strict protocols, such as separating flu patients from others in waiting rooms, frequent cleaning, and using personal protective equipment (PPE), help maintain infection control. It’s easier to control an environment that is smaller and better for the overall economy to support smaller practices, like more NP and PA practices.

ICT: In your opinion, how do leadership qualities like empathy and emotional intelligence play a role in managing burnout within infection prevention teams, and how can NPs and PAs contribute to fostering such leadership?

AP: NPs and PAs are uniquely positioned to foster leadership qualities within infection prevention teams. As frontline health care providers, they deeply understand their teams' demands and pressures. By leading with compassion, they can model empathy and emotional intelligence in their daily interactions, promoting a culture of support and collaboration. NPs and PAs can also advocate for their teams, pushing for policies prioritizing mental health resources, fair workload distribution, and opportunities for staff to voice concerns. Their leadership can significantly contribute to preventing burnout and maintaining high infection control standards during challenging times. By creating an environment where team members feel heard and valued, leaders can reduce stress, boost morale, and enhance overall job satisfaction, ultimately leading to better patient care and a more resilient workforce.

ICT: The World Health Organization (WHO) recently classified burnout as a medical condition. From your perspective, in infection prevention, what specific steps can health care organizations take to protect their staff, particularly in high-stress environments like yours?

AP: This has been coming for some time. With the immediate and long-term side effects that come from so much mental anguish, depression, and stress, the WHO should have classified burnout as a medical condition before COVID-19. Health care organizations must proactively protect their staff, particularly in high-stress environments like infection prevention. One critical step is establishing comprehensive wellness programs focusing on mental health support. This could include offering access to counseling services, stress management workshops, and mindfulness training. Regular mental health check-ins, where staff can discuss their stress levels in a safe, nonjudgmental environment, can also help detect burnout early. This is more easily accomplished and maintained over time in smaller practices than in larger institutions or hospitals. A strong culture of teamwork and support within infection prevention teams also helps to keep morale positive and low stress.