As a seasoned nurse practitioner, I’m pretty confident in my own abilities and in those of my NP and PA colleagues. Yes, there are some big educational differences between nurse practitioners, physician assistants and physicians, however in practice each of these types of professionals is highly effective in the clinical setting. Regardless, a constant friction between professional groups, particularly those for nurse practitioners and physicians, about the legitimacy of advanced practice professions wears on.
Physician groups argue that nurse practitioners should not be allowed to practice independently whereas NPs disagree and fight to work free of physician oversight.
The controversy is a difficult one to iron out. How does one prove on a healthcare-wide scale that nurse practitioners and physician assistants provide safe and effective care? So far in this debate, we have turned to a handful of studies that look at various aspects of NP and PA efficacy and safety.
Several months ago, another such study was added to the advanced practice provider arsenal. A study published in the Annals of Internal Medicine compared the use of low-value healthcare services among advanced practice clinicians (nurse practitioners and physician assistants) and physicians. In other words, the study looked at the number of unnecessary tests each group of providers ordered or number of unnecessary antibiotics each group prescribed. Morse specifically, researchers looked at the following potentially unnecessary clinical measures:
- Prescribing of antibiotics for upper respiratory infection
- Use of radiography for uncomplicated low back pain
- Use of CT scans and MRI for headaches
The outcome? Advanced practice clinicians (APCs) ordered about the same number of potentially unnecessary tests as their physician counterparts. While one could say the conclusion is somewhat disconcerting in that healthcare providers are ordering unnecessary testing and prescribing unnecessary medications at all, author’s takeaway was that “APCs and physicians provided an equivalent amount of low-value health services, dispelling physicians’ perceptions that APCs provide lower-value care than physicians for these common conditions”.
This study, and the growing body of evidence supporting NP and PA’s efficacy as healthcare providers is timely. As nurse practitioners and physician assistants continue to become more integrated into our nation’s healthcare delivery system, patients can rest assured that they’re getting excellent care whether from an NP, PA, or MD. And, keeping with the mission of adopting the highest standards for our practice, let’s stop prescribing antibiotics for URIs!
What other studies have you found that support advanced practice provider’s role in healthcare?
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