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Advanced Practice Clinicians: Caring for Patients in All Areas of Medicine

Advanced Practice Clinicians

When you are treated in just about any health-care setting, you likely interact with a talented group of medical professionals known as advanced practice clinicians (APCs)—nurse midwives, nurse anesthetists, nurse practitioners, and physician assistants. At Penn Medicine Lancaster General Health, approximately 438 APCs comprise 31 percent of the medical staff.

We’re breaking down the training and responsibilities of each role to help you better understand the teams who are helping to keep you well.

Who Are Nurse Midwives?

  • Certified nurse midwives (CNMs) are registered nurses who hold a bachelor’s degree (and either a master’s or doctoral degree), from one of 40 accredited midwifery programs in the U.S. Recertification is required every five years.
  • CNMs attend births and provide general health care throughout a woman’s life.
  • According to the American Congress of Obstetricians and Gynecologists, 49 percent of U.S. counties do not have obstetric care providers, and a 25 percent shortage of OB/GYNs is predicted by 2030. CNMs are valuable in meeting women’s health-care needs.

Who Are Nurse Anesthetists?

  • Certified registered nurse anesthetists (CRNAs) are advanced practice registered nurses. They administer approximately 49 million anesthetics to patients in the U.S. each year.
  • Nurse anesthesia programs range from 24-51 months, depending on university requirements. Students graduate with a minimum of a master’s degree and have an average of 9,369 hours of clinical experience. 91 of the 121 programs are approved to award doctoral degrees by 2022.
  • Nurse anesthetists follow a Continued Professional Certification Program comprised of two, four-year cycles each, requiring 60 continuing education credits, 40 professional activities credits, four core modules, and a performance standard assessment at the end of the eight-year cycle. 

Who Are Nurse Practitioners?

  • As of January 2019, more than 270,000 nurse practitioners (NPs) are licensed to practice in the U.S. Over the next decade, the U.S. Bureau of Labor Statistics estimates this number will increase 35.3%.
  • Nurse practitioners obtain a master’s or doctoral degree and are trained in the advanced practice of nursing in specific concentrations including family/across the lifespan, primary or acute adult-gerontology, women’s health, neonatal, primary or acute pediatrics, and psychiatry-mental health.
  • NPs work in a variety of settings including private practice (24.2%), hospital outpatient clinics (14.5 %), inpatient hospital units (12.1 %), emergency rooms (3.1%), urgent care (4.3%) and community health centers and Federally Qualified Health Centers (8.1%). 

Who Are Physician Assistants?

  • Physician assistants (PAs) are educated at the master’s degree level. They train for 27 months using a curriculum modeled on medical school education, and complete at least 2,000 clinical rotation hours.
  • Over the next decade, the U.S. Bureau of Labor Statistics predicts employment of PAs will increase 30.4.
  • To maintain their certification, PAs must attain 100 hours of continuing medical education credits every two years, and recertify every 10 years through an examination that evaluates general medical knowledge.
author name

Ashley R. Kliewer, MS, PA-C

Ashley R. Kliewer, MS, PA-C, is a physician assistant with LG Health Physicians Hospitalists and Director of Advanced Practice for Lancaster General Hospital. She is a graduate of Philadelphia College of Osteopathic Medicine.

Call: 717-544-8144

About LG Health Hub

The LG Health Hub features breaking medical news and straightforward advice to help individuals of all ages make healthy choices and reach their wellness goals. The blog puts articles by trusted Lancaster General Health clinical experts, good 'n healthy recipes, videos, patient stories, and health risk assessments at your fingertips.


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