• Physician extender;
  • midlevel providers;
  • practice management;
  • cost–benefit;
  • Level of Evidence: 5.


Physician extenders may be a valuable asset to an outpatient otolaryngology practice. The adjunctive care provided by physician extenders appears to be cost effective and has the advantages of increasing patient education, promoting physician productivity, and improving management of chronic conditions. Practice types that may benefit from advanced practice providers include group or solo practices with high demand or who need improved efficiency. We discuss five different practice models for incorporation of advanced practice providers in an outpatient otolaryngology practice. These models include scribe, collaborative, limited independent, partial independent, and near complete independent practice and are based primarily on the autonomy level of the physician extender. In additon, we examine available literature discussing the cost effectiveness of physician extenders used in an outpatient setting.