Who Provides More Unnecessary Care: Physicians or Nurse Practitioners? (The Answer Is Surprising)
Imagine you have been struggling for eight days with a bad cough, with what feels like a lifetime’s worth of secretions in your upper airways. When you called your primary care physician’s office, she wasn’t available, so you got an appointment with a nurse practitioner, who prescribed a course of antibiotics. Would you fill the prescription? Would you be confident the nurse practitioner was well trained enough to make that judgement? More generally, do non-physician primary care clinicians–like NPs or PAs–risk our health by ordering unnecessary tests and services?
Many Americans have a hard time getting timely access to primary care physicians. In response, some experts say we should expand the role of nurse practitioners and physician assistants in providing primary care. But many people are concerned that such clinicians will offer lower quality of care than their physician counterparts. They worry, for example, that nurse practitioners will refer many people to subspecialists who could have been taken care of by primary care physicians. They’re concerned that physician assistants will order unnecessary tests when patients present with signs or symptoms they don’t feel comfortable addressing.
It is probably time to put these concerns aside. When it comes to reducing unnecessary healthcare services, primary care physicians are no better than their less-lengthily-trained primary care colleagues.
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