Chief APPs take command as hospitals rethink workforce

By 2026, major systems were no longer treating advanced practice provider leadership as an informal management function but as a named executive office. On Becker’s Healthcare Podcast, UChicago Medicine introduced Brooke Schweitzer as its “Chief Advanced practice officer,” and she called it an “inaugural position” responsible for “leading the strategy and structure” for APPs, language that shows the role was created to formalize authority at the top of the organization rather than leave APP oversight dispersed across departments or dependent on physician or nursing leadership alone.

The same pattern appears in large multistate systems, where APP leadership is being built into executive governance structures with enterprise scope. At Advocate Health, the speaker states that “both of you are VPs of advanced practice” and explains that “Brittany and I lead over 7,000 advanced practice professionals across two very diverse geographies,” while also stressing “regulatory complexity that is different state by state” and adding that “in the North Carolina Georgia division, we have over 4,000 employed apps… and… total… maybe 9,000 apps, both employed and affiliated,” evidence that dedicated senior roles were being established to oversee APPs at scale.

The workforce math is changing fast enough that health systems can no longer treat advanced practice providers as a secondary staffing category. Why a Dedicated APP Executive Is Crucial for Strategy argues that “apps are going to make up 50% of the employee clinician workforce in this country by 2033,” and says Advocate Health is moving even faster, with its North Carolina, Georgia division “at around 46% of the clinician workforce” and its Wisconsin Illinois division “sitting at around 40% of our clinician workforce being apps,” evidence that APPs are becoming a defining share of frontline clinical labor.

As that share rises, APPs are not just filling gaps but carrying more of the day-to-day responsibility for delivering care, which changes what leadership has to manage. The same discussion ties APP growth to the need for leaders who can see operations through an “APP lens,” because when such a large and expanding segment of clinicians shapes patient flow, quality, and team performance, elevating APPs into executive decision-making becomes less symbolic than structural—a response to a workforce that is bigger, more central, and more consequential to care delivery than before.

The case for a chief APP leader is often less about prestige than about fixing daily operating failures that leave clinicians underused, unsupported, and more likely to leave. On Becker’s Healthcare Podcast, Advocate Health traced its APP leadership buildout to a period when there was “no centralized way of even communicating, orchestrating, looking at rules and regulations,” prompting the 2013 launch of a “Center for Advanced practice” to “create an infrastructure to support apps”; leaders also tied the move to engagement findings that APPs felt underutilized, which they described as a leading driver of turnover.

The role also addresses fragmentation on the ground by giving APPs clear supervision, advocacy, and a consistent operating model instead of scattered oversight across departments and practices. Becker’s Healthcare Podcast described a structure in which “over 70% of our apps in our system report directly to an app leader, where they have someone that they can go to,” crediting that “network of leaders to rely on” as part of its success, while separate guidance said organizations should create senior APP leadership when they face access constraints, turnover, inconsistent practice, compliance risk, or split ownership of compensation, credentialing, and workforce planning.

The clearest evidence that APP executive infrastructure can produce measurable gains comes from UChicago Medicine, where Brooke Schweitzer, DMSc, PA-C, told Becker’s that the system “cut advanced practice provider turnover by 10% in 3 years,” saved “$25 million in direct costs,” and improved access after building out centralized APP leadership. Becker’s also reported turnover fell “from 19% to 9% over the course of four years,” engagement scores improved, and the system generated “$10 million in the last year alone in professional revenue tied to the clarity in roles and expectations,” linking retention and productivity to a defined operating model.

Just as important, the gains were not framed as a one-off staffing fix but as the result of executive infrastructure: UChicago began in 2024 after hiring Schweitzer as its “inaugural chief advanced practice officer” in late 2023; the system created the “Center for Advanced Practice,” launched APP “individualized scorecards,” and formed a multidisciplinary task force with “more than 100 meetings.” On Becker’s Healthcare Podcast, Schweitzer said, “Unfortunately, we had really high turnover numbers within the last three years… With this role clarity… we’ve seen pretty dramatic results,” including “a dramatic increase in productivity by more than 27% over the last two years” and “a 200% increase in the number of clinics that were hosted by apps.”