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Popul Health Manag. 2013 Aug;16(4):242-5. doi: 10.1089/pop.2012.0092. Epub 2013 Mar 28.

Nurse practitioners and physician assistants are complements to family medicine physicians.

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Department of Family Medicine, Mayo Clinic-Rochester, Rochester, Minnesota 55905, USA.


Controlling the overall cost of medical care requires controlling the number of physician visits. Nurse practitioners and physician assistants (NPs/PAs) may function as lower-cost substitutes for physicians or they may complement physician services. The association between NP/PA and physician visits when NPs/PAs are not working as primary care providers (PCPs) has not been thoroughly studied. A sample of 400 family medicine patients drawn from 1 large multisite practice was studied using multiple logistic regression analysis. NPs/PAs did not function as PCPs during the study period. Patients were defined as outliers if they visited physicians more than 5 times in a year. Patients who visited NPs/PAs in non-retail clinics were significantly more likely to be physician visit outliers. Visits to NPs/PAs in retail clinics were not related to physician visits. NP/PA visits in standard medical office settings complement physician visits when the NPs/PAs were not working as PCPs in this large multisite practice. Health care reform proposals relying on increased use of NPs/PAs may be more cost-efficient if NPs/PAs are located in retail settings or function as PCPs.

[Indexed for MEDLINE]

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