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More patients accepting treatment from nonphysicians
By Andis Robeznieks
Posted: June 4, 2013 - 1:15 pm ET

As predictions of a looming doctor shortage become more severe, two recent surveys find that more family physicians are working with nurse practitioners, physician assistants and certified nurse midwives. They also found that patients increasingly are accepting treatment by nonphysicians—particularly when the alternative is to wait a day or longer to see a doctor.

According to a policy brief published in the Journal of the American Board of Family Medicine, nearly two-thirds (59.8%) of the 5,818 family physicians surveyed said they routinely worked with an NP, PA or CNW. The brief, written by physicians affiliated with the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, cited previous studies that physicians working with these mid-level professionals grew from 25% in 1999 to nearly 50% in 2009. The online survey was conducted between September and October of 2011.

“This survey shows that family physicians are embracing collaborations with nurse practitioners, physician assistants and other health professions colleagues,” co-author Dr. Andrew Bazemore, director of the Graham Center, said in a news release.

Another survey, published in Health Affairs, found that people still prefer to see a doctor, but are OK seeing a nonphysician provider if that means getting treated more quickly. Even then, there was not an overwhelming preference for doctors. The survey asked respondents if a practice had physicians, physician assistants or nurse practitioners, who would they prefer to see? Just over half (50.4%) said they would prefer to see the physician, while 25.9% said they had no preference, and 22.8% preferred an NP or PA.

The survey then provided two scenarios: Would you rather see an NP or PA today for a worsening cough, or wait to see a physician tomorrow? And would you prefer to see an NP or PA in one day, or a physician in three days for frequent headaches? In the first scenario, 59.6% preferred to be treated that day by a nonphysician (15.1% had no preference or were unsure). In the second, 66.6% said they would rather see an NP or PA the next day (11.3% had no preference or were unsure).

“State regulations limiting scope of practice for physician assistants and nurse practitioners present a major practical barrier to these clinicians' expanded role in care,” the report concluded. “Efforts to standardize scope of practice for physician assistants and nurse practitioners at a level that enables them to take full advantage of their training and skills have the potential to improve access, especially for underserved populations.”

The report, written by researchers with the Association of American of Medical Colleges, was based on a survey of 2,053 adults who indicated that they or a physician believed that they needed medical care at least once in the past 12 months.

http://www.modernphysician.com/article/20130604/MODERNPHYSICIAN/306049973?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGJVdjBGRWxYek9UYktwUGZUamg5b1g4WFFERmhzbHhWSnRqYk9XNkU9&utm_source=link-20130604-MODERNPHYSICIAN-306049973&utm_medium=email&utm_campaign=mpdaily