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ANN ARBOR---The growing presence of nurse practitioners and physician assistants in medical offices is fueling an ongoing debate with physicians over the best ways to deliver primary care.

The presence of nurse practitioners and physician assistants, and the debate that surrounds it, is the subject of a new study by Peter D. Jacobson, associate professor of health management and policy at the University of Michigan School of Public Health, and colleagues. The article in the new issue of the journal Inquiry examines the role of nurse practitioners (NPs), physician assistants (PAs) and physicians in today's managed care environment.

The article, "Nurse Practitioners and Physician Assistants as Primary Care Providers in Institutional Settings," focuses on NPs and PAs at nine health maintenance organizations (HMOs) and multispecialty clinics (MSCs). Physicians were also interviewed, most of whom spoke favorably about NPs and PAs, but some did not.

"In our study we discuss the expanded scope of practice and autonomy of NPs and PAs. It clearly indicates a potential shift of primary care responsibility from physicians to NPs and PAs. Patients should be made aware of who provides primary care and who controls referrals," Jacobson said.

What exactly is a nurse practitioner? What does a physician assistant do? Better yet, what are they trained to do? How do physicians feel about their role in the health care profession? Those are some of the questions Jacobson addresses.

Nurse practitioners are registered nurses whose formal education and clinical training extend beyond the basic nursing licensure requirements. NPs are trained to diagnose and recommend treatment for common acute illnesses, disease prevention, management of chronic illnesses and a host of other primary care services.

Physician assistants are usually trained by physicians alongside medical students. PAs are awarded a certificate of completion rather than an advanced degree.
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Contact: Amy Reyes
amelynr@umich.edu
734-647-4411
University of Michigan
17-Mar-1999


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