Podcast Summary: The Expanding Role of Physician Assistants at Mount Sinai with Heather Isola
Podcast: Becker’s Healthcare Podcast
Episode: The Expanding Role of Physician Assistants at Mount Sinai with Heather Isola
Date: February 14, 2026
Host: Scott Becker
Guest: Heather Isola, Vice President of Physician Assistant Services, Mount Sinai Health System
Episode Overview
This episode explores the evolving role of Physician Assistants (PAs) within the Mount Sinai Health System and the broader trends influencing advanced practice providers (APPs) in U.S. healthcare. Heather Isola shares her career journey from clinician to system leader, discusses the challenges and opportunities in expanding and standardizing the PA workforce, and provides insights into creating collaborative care models for the future. The discussion is rooted in real-world examples from Mount Sinai, one of the largest and most innovative health systems in the country.
Key Discussion Points & Insights
Heather Isola’s Background & Career Path
[01:23–03:10]
- Started in community medicine (HIV and Hepatitis C), transitioned into women’s health, and joined Mount Sinai’s OB/GYN department.
- Progressed into leadership roles, ultimately becoming the inaugural Director of PA Services, now Vice President.
- Played a key role during COVID-19 in elevating the need for PA and NP (Nurse Practitioner) executive leadership in health system management.
- Focused on strategy, operations, and retention for the Center for Advanced Practice Providers.
Notable Quote:
“I loved figuring that all out... in order to have great patient care delivery, there’s about 70 other processes that have to happen before you see a patient.”
— Heather Isola, [03:10]
Transition from Clinical Practice to Leadership
[02:48–05:54]
- From being a “doer” as a PA to a leader optimizing the system.
- Early involvement in interdisciplinary and operational projects spurred her move into system-level change.
- Recognized the importance of quantifying and optimizing the PA/APP workforce and moving away from siloed department structures.
- COVID-19 highlighted the adaptability of PAs and NPs and accelerated organizational changes.
Notable Quote:
“A lot of APPs have this ability to see the things that we’re doing in healthcare above and below and to the sides. We’re a great middleman, we see everything. So that makes us great at strategy and operations.”
— Heather Isola, [05:15]
The Future of Primary Care & Team-based Models
[05:59–08:41]
- Physician shortages have driven the rise of PAs and NPs in primary care.
- State-by-state variation in practice authority remains a major factor—New York allows NPs full practice authority, but this isn’t universal.
- The future is a collaborative, team-based care model: combinations of MDs, NPs, and PAs serving large patient populations.
- “Top of license” practice is a great concept, but challenging to implement in real life.
- Measuring success should consider throughput, patient retention, experience, and efficiency, not just revenue.
Notable Quote:
“If you have a physician and an NP and a PA or a physician and two PAs... those three people can take care of 10 times the amount of people if just one of them did. So really taking care of a population within a practice... it really is a collaborative sport.”
— Heather Isola, [07:30]
Ensuring Consistent Quality of Care
[08:41–11:55]
- Training programs provide a strong clinical foundation, but transition-to-practice support is critical (especially since PAs/NPs don’t have formal residencies).
- Initial 2–3 years are vital for instilling professional behaviors, clinical judgment, and patient communication.
- Systems and institutions must create educational and operational support for APPs to thrive.
- Work environment, mentorship, continuing medical education, and HR support all contribute to high performance and patient outcomes.
Notable Quote:
“You’ll get a good PA or NP if they’re well-supported, well-educated, have access to CME... It’s all those things that make an employee shine, right? And then that translates to great patient care.”
— Heather Isola, [11:00]
Strategic Focus and Innovation for 2026
[12:07–13:15]
- Heather’s key focus: Perfecting “top of license” models at scale across seven hospitals and numerous practices.
- Developing a playbook for optimizing advanced practice provider efficiency, sustainability, and innovation in response to workforce challenges.
- Linking APP goals and metrics to the health system’s balanced scorecard for long-term resilience and impact.
Notable Quote:
“I am really excited to break into that and come up with a playbook... to answer our resiliency in healthcare and how we can be innovative and then how can we be efficient with the person power we have.”
— Heather Isola, [12:45]
Memorable Moments & Quotes
-
On the hidden complexity of good care:
“There’s about 70 other processes that have to happen before you see a patient.”
— Heather Isola, [03:18] -
On the collaborative future of primary care:
“It really is a collaborative sport and I think we just all need to move in that direction to efficiently care for a large population. There’s not enough of us.”
— Heather Isola, [08:28] -
On the importance of supportive environments:
“All of the good behaviors... it’s all around how supportive of a work environment you’re in.”
— Heather Isola, [10:38]
Timestamps for Key Segments
- Heather Isola’s background & introduction: [01:23]
- Transition to leadership & role expansion: [02:48–05:54]
- Future of primary care & collaborative roles: [05:59–08:41]
- Standardizing clinician quality and training: [08:41–11:55]
- Strategic focus for 2026 at Mount Sinai: [12:07–13:15]
Conclusion
Heather Isola offers an inside look at how Mount Sinai and progressive health systems are leveraging PAs and other advanced practice providers to meet dramatic shifts in healthcare needs. The emphasis on teamwork, support, innovation, and measurable outcomes offers a hopeful and actionable blueprint for health leaders navigating workforce shortages, quality, and the complexities of modern care.