Physician to APP Staffing Ratios

I work in a pediatric facility. We have had a collaborative practice for the last 17 years between MD and APPs. Our current ratio is 30 MD FTE and 20 APP FTE. We are currently having discussions about complexity and how to balance that. Would love to hear what you are finding other places do as well!
reach out if you have any further questions for me!
Jen Weyandt
jen.weyandt@childrensmn.org

@Brian Schroeder currently working in an organization that is smaller and has 18 hospitalist physicians and 3 APPs, one of whom is dedicated to nights and works alongside a physician colleague. Some variables we have considered at this location as well as my prior (which was an academic medical center where the hospitalist team had many “roles”):

Physician tolerance to carry higher census rounding with an APP

APP as admitter to buffer rounding physicians from distraction (and does that promote higher starting census for a physician)

Flexibility (which has frankly been a limiting factor for many models)

@Brian Schroeder
We have 5 MDs and 2 APPs working on any given day. 1 MD with 1 APP at night. The community PCPs were recently asked by the administration to hand over all their patients to the hospitalists and thus our census is expected to rise. The administration is considering adding a 3rd APP during the day instead of another MD to make it financially sound. We however think the census may go high enough to add another FTE MD. The APPs generally see about ⅔ of the caseload of an MD. Also, at the end of the day we MDs are responsible for the work that APPs do and thus it is extra work for us without extra compensation