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Increasing roles of nurse practitioners and physician assistants in healthcare

Alex Proimos

As the United States experiences a doctor shortage, more patients are seeing nurse practitioners and physician assistants for the diagnosis of routine ailments.

This week on “Take Care,” Dr. Atul Grover discusses the differences between nurse practitioners and physician assistants. Grover is chief public policy officer of the Association of American Medical Colleges.

Demands on the healthcare system have never been greater and because of this nurse practitioners and physician assistants are playing a greater role in healthcare.

“They have historically been trained to be aiding a physician and the rest of the healthcare team with tasks that can be safely delegated to somebody with a different level of education and training,” says Grover.

Physician assistants, or PAs, are now required to have a master’s degree. A PA program includes three years of classroom education that is similar, if not identical, to that received by medical students. This education is followed by roughly 2,000 hours of clinical training. A lot of training is received on the job and all PAs must be nationally certified and be licensed by the state in which they work.

Nurse practitioners, or NPs, are usually registered nurses with a bachelor’s degree as well as a master’s degree. This advanced degree program includes at least two years of classroom and clinical experience, depending on the program. Those who go on to get their doctorate degree could have as many as 5,000-6,000 hours of clinical experience.

NPs also tend to get some on-the-job. Many states, about 20, allow nurse practitioners to practice independently with limited supervision from a physician, while in other states NPs work alongside a physician.

Studies in the primary care setting have shown similar patient results between independent advanced practice nurses and physicians. The Health Resources and Services Administration (HRSA) of the federal government says that 75 percent of what a primary care physician sees and does can be done by an advanced practice nurse. Grover, however, thinks that this statistic might be a stretch and that the right balance is currently unknown.

“We’re evolving away from independent practice, from the sort of gladiator doctor that’s just seeing the patient, to more of a team approach,” says Grover.

As a result, Grover says this information will become more difficult to study and future research will most likely be done on how well teams function rather than how well individuals function.