Neuroscience Group of NE Wisconsin

Setting the Standard for Comprehensive, Compassionate Brain, Spine and Pain Care

Fox Valley - Nov. 13, 2007. Neurological and neurosurgical patient care is improved when physicians (MDs) and Associate Practitioners (AP) (nurse practitioners and physician assistants) work as a team. November 11th-18th is national NP Week. We are celebrating more than 4 decades of NP practice and research. Did you know?

The US has over 120,000 practicing NPs
6000 New NPs are prepared each year and & 88% have graduate degrees
NPs write more than 470 million prescriptions with a retail value of $28 billion each year
96.5% of NPs prescribe medications and write an average of 19 prescriptions/day
2/3 of NP’s practice in primary care, the remaining 2/3 practice in inpatient, ER or specialty practices
92% maintain national certification (Nursing Matters, Nov. 2007).

At the Neuroscience Group of NE Wisconsin, physician-NP teams provide convenient care to patients by improving access to care, coordinating care and sharing in the responsibilities of patient care, such as follow-up calls, providing reports on diagnostic findings, ordering medications and other treatments. By working together, the team can provide care to more patients. The combination of physician and NP skills puts more emphasis on coaching patients on prevention, wellness and how to better meet their health care needsThe APs provide inpatient and outpatient medical and surgical support to neurological and neurosurgical patients and their families. This includes listening to patient histories and conducting physical exams. The MD-AP team works to identify, treat, and manage chronic diseases such as epilepsy and multiple sclerosis. Both MDs and APs diagnose, plan and implement interventions and treatments. Both MDs and APs order and interpret diagnostic tests such as MRI studies, Cat Scans, x-rays, blood work, and EKG's. Both MDs and APs prescribe medications, physical therapy, massage therapy, and other rehabilitation therapy for patients with neurological diseases. Some APs provide surgical support in the operating room and perform procedures in the clinic such as suturing and refilling pain pumps. APs provide patient and family education to allow patients to make decisions about their own health. APs provide emotional support, and are excellent patient advocates. As specialists in neurological and neurosurgical care, the MD-AP teams work in collaboration with the patient’s family doctor to coordinate care.

Penny Bernards, APNP coordinates the Headache Clinic for the Neuroscience Group. In conjunction with Dr. Steven Price, Ms. Benards has provided individualized care and coaching to hundreds of patients over the past nine years. Each new headache patient receives a 1-hour initial consultation with Ms. Bernards. The patient, Dr. Price and Ms. Bernards then work together on a plan of care, which may include medications to control/alleviate symptoms, dietary changes, exercise prescriptions and stress-reducing activities. The patients frequently consult with Ms. Bernards via phone for follow-up advice and help with managing their medications. One patient noted, “if it weren’t for Penny, I would not be able to function effectively in my role as a senior executive in a very fast-paced corporate environment. She listens to me and has been a great coach in managing and mitigating the effects of chronic migraine headaches.”

Diane Vanderlin, APNP has worked extensively with Dr. Philip Yazbak to care for patients with chronic pain, utilizing implanted intrathecal pain pumps. On a routine basis, the patients return to the clinic to have medications added to a pump implanted in their abdomen. Ms. Vanderlin monitors the pre-implant trials for patients considering this modality. She determines the type of medication and helps the patient to titrate the medication delivery to best manage pain. Together, MS. Vanderlin and Dr. Yazbak care for over 150 patients with implanted pumps. One patient noted, “Diane and Dr. Yazbak make a great team. They have been taking care of me for years. If it weren’t for them, I would not be able to continue to be active at home.”

Jill Hietpas, PA-C works with neurosurgeon, Dr. Randall Johnson to provide pre and post-op care for patients undergoing invasive surgery. Hietpas noted, “Advances in navigational procedures in the operating room have helped to improve patient safety and post-surgical outcomes. As a team, Dr. Johnson and I work to insure that the most effective technologies are integrated in our practice.”

Philip Yazbak, MD, F.A.C.S., president of the Neuroscience Group commented, “The physician assures that the associate practitioner is providing patient care that is within the scope of his/her license, certification, education and training and/or applicable state and federal regulations. Our physicians monitor on an ongoing basis the clinical competence and professional conduct of the AP and provides assurance that an annual competency assessment is completed. As physicians, we feel that the team-based approach is most beneficial for our patients.”

MDs and APs are required to be licensed in the state(s) in which they practice and must be credentialed by a recognized national credentialing organization. Hospitals, health systems and insurers require additional credentialing. The Neuroscience Group of NE Wisconsin provides a wide spectrum of neurological and neurosurgical services throughout NE Wisconsin. These services include care for patients with serious health care concerns like epilepsy, Parkinson’s disease, headaches, multiple sclerosis, peripheral nerve diseases as well as surgical procedures for spine, brain and peripheral nervous system disorders.