Why Tia Embraces a Nurse Practitioner Forward Model
Tia Tackles

Why Tia Embraces a Nurse Practitioner Forward Model

By Jessica Horwitz, MPH FNP-C
Chief Clinical Officer, She/her

7 min read

From the very beginning, our mission at Tia has been to redefine women’s health for patients and providers alike — to allow the people under our care to live in greater vitality. We have understood that healthcare that really helps people to be healthier needs to not only deliver different care but also deliver care in a different way. This differentiated model has enabled us to earn the privilege of caring for thousands of women across New York, Arizona and California. It has allowed us the opportunity to demonstrate exceptional quality outcomes and scalable operations with an interdisciplinary clinical team that is, for the first time ever, nurse practitioner forward.

What exactly are Nurse Practitioners?

Nurse Practitioners, or NP’s, are clinicians who have earned a master's or doctoral degree in nursing and have completed advanced clinical training in diagnosis, medical management and pharmacology. They also receive training in prevention and often approach medicine through a more holistic and collaborative lens. This training, and especially the focus on patient experience and collaborative decision-making, is exactly why we leaned into an NP forward care model at Tia. The training and clinical background of our nurse practitioners and our innovative Tia training program give them a unique blend of clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and healthspan (healthspan = how many healthy years you live,not just how many years you live). This blending of treatment and prevention is core to Tia’s care model. And nurse practitioners, especially when working part of a multidisciplinary team that includes physicians, physician assistants, acupuncture providers, midwives working in primary care, nurses, and mental health practitioners, have a skillset and passion that helps you, as our patient, to remain healthy and vibrant under their care. Nurse practitioners are excellent at primary care, and have proven to be excellent in delivering the integrated primary care we are proud to stand by.

Many healthcare organizations utilize nurse practitioners as part of their care team, however, they are often extensions of the physicians and deployed as cost-saving measures. The physician is the patient’s primary provider of record. The patient may see a nurse practitioner for an acute need or when the physician is busy or out of the office. Other models have nurse practitioners staffing the clinic with a single physician who is very loosely engaged in care, overseeing a practice caring for thousands of patients. The average primary care physician in the US holds a panel of 2500 patients. This means one physician is responsible for keeping 2500 people healthy, and knowing 2500 people’s health histories, health goals, and health risk factors. And being available for their acute and ongoing needs. This is impossible, even for the most diligent and thorough of practitioners. While we see value in practices that use NPs as extensions of physicians — we also saw an opportunity.

How and why does Tia work with Nurse Practitioners?

We saw an opportunity to design a care model that allowed nurse practitioners to thrive as holistic primary care practitioners while also building care teams that allowed our incredible physicians to practice in a setting that valued their unique and highly pointed skill set. This model would not only meet our primary goal of keeping YOU as our patient healthy over your lifetime, but would also allow our clinicians to continue to be challenged — to practice with autonomy and to find fulfillment in medicine, something we know combats burnout and keeps high-quality clinicians happy and engaged. When a patient is “under the care of one physician” but often sees an NP or PA for isolated episodic needs, the whole picture of health is missing. Similarly, in models where clinics are fully staffed by NPs and PAs with a single physician providing oversight over many clinics and practitioners without regular engagement, clinicians and patients miss out on the ability to collaborate with physicians in a more integrated way. Physicians bring a level of depth and diagnostics that is appropriate and necessary for some more complex patients, and their expertise benefits everyone when interdisciplinary care teams can collaborate together.

At Tia we have built a relational primary care model where you are cared for entirely for your preventative health needs, your ongoing health concerns, and the days you wake up not feeling well and need medical help. This happens because we enable our clinicians: nurse practitioners, physicians, midwives, and physician assistants, to build relationships with you over time. We also build structures for our clinicians to collaborate and build relationships with each other — to ensure that you are connected to the right provider, for the right concern, at the right time. We want you to see your primary care provider over time, but we also want to make it easy for you to see other clinicians at Tia with different expertise if and when they might be a better fit for your unique health needs, health complexity, and personal goals. The intentional way we utilize clinicians of various clinical backgrounds is just one way we are building a new model of care — with you, and for you.

You may still be wondering what it means to have a nurse practitioner as your healthcare provider. If so, this breakdown may be a helpful resource.

Who can prescribe medications for me?

Nurse practitioners, physician assistants, and physicians can all prescribe medications for you.

Can a nurse practitioner complete a referral for a specialist for me?

Yes! Nurse practitioners, physician assistants, and physicians can complete referrals for specialists. Some insurance plans (in some states) may require the referral to be from a physician. If this is the case, you may see one of our physician’s names on a referral order for you.

Is a nurse practitioner and a nurse the same thing?

No. All nurse practitioners are also nurses. After completing nursing school - nurse practitioners complete a masters or doctorate degree focused on diagnosis, medical management, pharmacology, and disease prevention. Some of our nurse practitioners completed additional training as part of a post-graduate residency or fellowships, where they earned additional specialized training. Many of our nurse practitioners worked as nurses before becoming nurse practitioners - in various settings - emergency medicine, labor and delivery, community health, oncology, fertility, etc.

What is the difference in training between a medical doctor and a nurse practitioner?

Physicians attend medical school (MD or DO programs) and then complete a residency in their specialty (family medicine, OBGYN, cardiology, surgery, etc). Nurse Practitioners attend nursing school and then complete a master’s degree in a particular clinical specialty to earn the title of Nurse Practitioner. (NP) Some nurse practitioners complete a doctorate program as part of their NP program or after. These nurse practitioners earn the title DNP or PhD. Some physicians and nurse practitioners go on to complete a fellowship where they earn additional specialized training.

Can I see a physician if I prefer?

Of course! While we are confident that you will receive the care you need from all of our medical providers - we respect your choices and preferences for all of your healthcare decisions. You can see the credentials of your provider when booking your appointment. Use this list to interpret what those letters behind their name mean:

MD - medical doctor (physician)

DO - doctor of osteopathic medicine (physician)

NP - nurse practitioner

DNP - doctorate of nursing practice (doctorate prepared nurse practitioner)

PA - physician assistant

CNM - certified nurse midwife - Did you know midwives do way more than deliver babies? Midwives are primary care providers with expertise in caring for women throughout their life.

RN - registered nurse

Ready to experience expert care from compassionate providers? Join Tia and schedule an appointment to begin caring for the whole you.

Located in New York, Phoenix, San Francisco, and Los Angeles.