madman
Super Moderator
Testosterone replacement therapy for physician assistants and nurse practitioners
Libert Ramos, Amir Shahreza Patel, Ranjith Ramasamy
Abstract: Physician assistants (PA) and nurse practitioners have been moving toward specialty practices, like urology. With increased training and education, they manage more complex conditions independently. Whether they are the primary provider or the follow up to a specialist, physician extenders can play a vital role in managing patients undergoing testosterone therapy. Physician extenders should be able to understand the indications, risks and associated adverse effects of administering testosterone in order to proficiently take care of patients with low testosterone. The goal of this review is to recognize the role and the limits to which physician extenders should manage hypogonadism, and when physician collaboration or referral is necessary.
Physician extenders are a growing force in healthcare today, often going beyond their initial role of complementing the growing shortage of primary care physicians (PCP). Currently, many physician assistants (PA) and nurse practitioners (NP) are moving toward specialty practices. However, mainstream curricula for PAs and NPs provide limited education in the specialty fields (1). Hypogonadism is a very common chief complaint in both endocrinology and urology (2). Of the males above age 40 who tested their testosterone levels, the incidence of low testosterone was 40% (3). Well trained PAs and NPs can manage most cases of hypogonadism requiring testosterone replacement therapy (TRT) independently. The goal of this review is to recognize the role and the limits to which physician extenders should be managing hypogonadism, and when physician collaboration or referral is necessary (4).
*Introduction to testosterone and hypogonadism
*Guidelines for TRT
- Diagnosis
- Treatment
- Contraindications and adverse effect
*Financial benefits
Conclusions
Symptomatic hypogonadism is a common complaint in urology offices and TRT is the gold standard of treatment. Physician extenders, like NPs and PAs, are capable of independently diagnosing and evaluating men with low testosterone levels and starting them on TRT when appropriate. It is vital that physician extenders understand the indications, risks, and adverse effects to ensure that patients are counselled and treated appropriately. Physician extenders must be familiar with the guidelines and recommendations about monitoring patients on TRT and must clearly understand when to consult and refer the patient to a specialist. Physician extenders do play an important role in the safe management of patients on TRT, as long as a proper treatment algorithm is established by the physician.
Libert Ramos, Amir Shahreza Patel, Ranjith Ramasamy
Abstract: Physician assistants (PA) and nurse practitioners have been moving toward specialty practices, like urology. With increased training and education, they manage more complex conditions independently. Whether they are the primary provider or the follow up to a specialist, physician extenders can play a vital role in managing patients undergoing testosterone therapy. Physician extenders should be able to understand the indications, risks and associated adverse effects of administering testosterone in order to proficiently take care of patients with low testosterone. The goal of this review is to recognize the role and the limits to which physician extenders should manage hypogonadism, and when physician collaboration or referral is necessary.
Physician extenders are a growing force in healthcare today, often going beyond their initial role of complementing the growing shortage of primary care physicians (PCP). Currently, many physician assistants (PA) and nurse practitioners (NP) are moving toward specialty practices. However, mainstream curricula for PAs and NPs provide limited education in the specialty fields (1). Hypogonadism is a very common chief complaint in both endocrinology and urology (2). Of the males above age 40 who tested their testosterone levels, the incidence of low testosterone was 40% (3). Well trained PAs and NPs can manage most cases of hypogonadism requiring testosterone replacement therapy (TRT) independently. The goal of this review is to recognize the role and the limits to which physician extenders should be managing hypogonadism, and when physician collaboration or referral is necessary (4).
*Introduction to testosterone and hypogonadism
*Guidelines for TRT
- Diagnosis
- Treatment
- Contraindications and adverse effect
*Financial benefits
Conclusions
Symptomatic hypogonadism is a common complaint in urology offices and TRT is the gold standard of treatment. Physician extenders, like NPs and PAs, are capable of independently diagnosing and evaluating men with low testosterone levels and starting them on TRT when appropriate. It is vital that physician extenders understand the indications, risks, and adverse effects to ensure that patients are counselled and treated appropriately. Physician extenders must be familiar with the guidelines and recommendations about monitoring patients on TRT and must clearly understand when to consult and refer the patient to a specialist. Physician extenders do play an important role in the safe management of patients on TRT, as long as a proper treatment algorithm is established by the physician.
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