Case 33: APP Leadership – The Basics

APP Angle. Resources for APPs.

This month’s case takes a different approach. Rather than focusing on a clinical scenario, we’re spotlighting leadership fundamentals for APPs and why they’re critical to the future of GI care.

Which of the following statements are true?

  1. Every successful project is the result of great leaders
  2. Not all great leaders are the same
  3. Personal traits and characteristics define leadership style
  4. All the above
Show Answer

The correct answer is D, all of the above.


BACKGROUND

  • As of 2025, advanced practice providers (APPs) are indispensable across all practice models.
  • APPs improve timely access to high-quality GI care.
  • APPs roles continue to expand beyond clinical care into  administrative, research, operations and leadership.
  • Subspecialized GI APPS are increasingly common, enhancing access to quality sub -specialty GI services.

WHY DOES GI NEED APP LEADERS?

  • Traditionally, leadership in GI has been physician, nurse, and/or administer-driven. However, the complexity and scope of APP roles require APPs to lead APPs. 
  • Challenges When Non-APP Leaders Direct APP Practice: 1,2
  • Solutions may not fully address APP-specific issues or workflow needs.
  • Variability in processes and expectations across teams.
  • Inconsistent or incomplete APP-focused policies (e.g., onboarding, competency assessment).3

BENEFITS WHEN APPs LEAD APPs1,2

  • More efficient and consistent workflows.
  • APP leaders help create and implement APP specific workforce processes, programs and solutions aligned with organization goals.
  • Measurable workforce impact:2
    • Increased APP engagement
    • Reduced turnover – often <2% with strong APP leadership
    • Appropriate utilization correlates with lower attrition

BUILDING APP LEADERS

  • To sustain a healthy GI workforce, organizations must intentionally develop and mentor APP leaders.
  • Establish a clearly defined lead APP role.
  • Integrate APP leaders as partners to physician, nursing and administrative leadership.
  • Leadership development for APPs should mirror that of physicians, emphasizing:
    • Patient-focused leadership
    • Organization-focused leadership
  • APPs want to lead!
    • 92% of APPs agreed or strongly agreed that they aspire to be leaders.4

LEADERSHIP STYLES

  • Every successful project is the result of great leaders.
  • Not all great leaders are the same.
  • Personality traits and characteristics shape individual leadership styles.
  • Two common and successful leadership styles in healthcare include:
    1. Transformative Leadership
      1. Inspires and motivates staff toward achieving organizational goals.
      2. Emphasizes vision and alignment with organizational values.
      3. Builds strong teams and fosters professional growth.
    2. Servant leadership
      1. Leads from a mindset of service.
      2. Prioritizes team needs and collective success.
      3. Creates a collaborative and supportive work environment.
      4. Promote staff development and empowerment.

TYPES OF INTELLIGENCE COMMON IN SUCCESSFUL LEADERS5

  • Intra-personal intelligence: introspective, emotional insight, recognition of personal strengths and limitations.
  • Inter-personal intelligence: Ability to understand others, emphasize and connect effectively.
  • Verbal-linguistic intelligence: Skilled with language, communication, teaching and articulating ideas clearly.

BARRIERS TO APP LEADERSHIP ADVANCEMENT

  • Lack of formal training or mentorship.
  • Limited clarity in career pathways.
  • Physician-centric governance structures.
  • Misalignment between responsibility and authority.
  • Organizational culture not accustomed to APP leadership roles.

APPs are vital to modern GI care, not just clinically, but as leaders shaping workflows, policies, and team success.

REFERENCES

  1. Mahoney MR, Beatty D, Kuriakose C, Anen T, Hartsell, Z.   The Key Role of Advanced Practice Providers in Today’s New Normal.  Physician Leadership Journal.  2021 March.  Accessed on December 2, 2025.  www.physicianleaders.org/articles/key-role-advanced-practice-providers-today’s-new-normal
  2. Noecker A, Hartsell Z, Anen T.   Advanced Practice Providers Leadership: The Evolution of a Well-Defined Structure.  Physician Leadership Journal.  2021 May.  Accessed on December 2, 2025.  www.physicianleaders.org/articles/advanced-practice-providers-leadership-evolution-well-defined-structure
  3. Enslin S, Kaul, V.  The Role of Advanced Practice Providers in Modern Gastroenterology Practice.  Clin Gastro Hepatol. 2024 Jul; 22: 1349-1352.
  4. Roberts AL, Rizzolo D, Bruza-Augatis M, Pontrelli, G, Zammit C, Banahan M.  PA’s perspective on leadership in medicine.  Journ Amer Acad Phys Assoc. Accessed December 2, 2025.  2024 Jul.  37:38-34.  www.journals.lww.com/JAAPA/abstract/2024/07000/pas_perspective_on_leadership_in_medicine.7.aspx
  5. Mehta K.  A Harvard psychologist says humans have 8 types of intelligence.  Which ones do you score highest in?  Accessed December 2, 2025.  Published Mar 10 2021.  www.cnbc.com/2021/03/10/harvard-psychologist-types-of-intelligence-where-do-you-score-highest-in.html?msockid=1c059302eefa69672f95879aef7c6802

Authors

Sarah Enslin, PA-C is a Physician Assistant at the University of Rochester Medical Center in Rochester, NY with over 10 years of experience as a practicing PA in GI. Sarah serves on several national GI committees and is a former member of the ASGE Practice Operations Committee and current member of the ASGE APP Committee. Sarah also serves Section Editor for Advanced Practice Providers for iGIE.

Joseph Vicari, MD, MBA, FASGE joined Rockford Gastroenterology in 1997 and has served as Managing Partner. He previously served as Chair of the ASGE Practice Operations Committee, Councilor on the ASGE Governing Board and Section Editor for Advanced Practice Providers for iGIE. He currently serves as Co-chair of the ASGE APP Committee.

Latest Articles