Landscape of Advanced Practice Provider Responsibilities in Pediatric Neurology.

Introduction: A worldwide shortage of pediatric neurologists, combined with increased demand, increased wait times, and clinician burnout, have led to substantial access limitations. Given these challenges, we need to ensure advanced practice providers (APPs) in pediatric neurology are utilized effectively. Our results provide a framework for optimizing modern pediatric neurology practice through a thoughtful consideration of APP integration. Methods: A survey was sent through two large neurology academic organizations. Emails were also sent to known professional contacts across 59 practice sites. An electronic survey in REDCap with 31 open-ended or multiple-choice questions about demographics, supervision, inpatient and outpatient clinical processes, procedures, and scholarly activities was sent. Results: Surveys were completed from 29 sites. Sixteen of these sites (55%) reported APPs do not have demographic restrictions in their outpatient practice. At many practice sites APPs perform inpatient consultations, with variable models for independence and partnership with attending neurologists. APPs subspecialize frequently and perform a variety of procedures including lumbar punctures and headache treatment injections. Conclusion: Most US-based APPs in outpatient pediatric neurology practice autonomously and also frequently perform procedures. APP independence in the inpatient setting should be expanded. As pediatric neurology practices evolve, information regarding the landscape of APP clinical responsibilities will aid in increasing access to care.