Advanced practice practitioners in allergy and immunology: Where are we now and future directions.

There has been substantial growth of advanced practice practitioners (APPs) in health care since their inception in the 1960s with APPs providing high-quality and cost-effective care in a variety of medical settings. Although most of the growth is in primary care, APPs are becoming increasingly leveraged in subspecialty care, including allergy and immunology (A&I). At present, there is limited literature on APPs in A&I specifically, but there is growing literature on APP utilization and training in other specialties. Structured transition-to-practice programs (including onboarding programs and formal residency/fellowships) for APPs in other specialties are increasingly common and are associated with improved clinical productivity, practice autonomy, expertise, confidence, and decreased turnover. It would benefit A&I to adopt a similar approach, as at present, the training and educational experiences APPs receive in A&I are quite varied. This article will review the training/certification of APPs, lessons learned from other specialties, what is known about the role of APPs in A&I, and next steps for the future.