Physicians and non-physician health practitioners: the characteristics of their practices and their relationships

• Published in: American journal of public health (1971) 1978-01, Vol.68 (1), p.44-48
• Main Authors: Simborg, D W, Starfield, B H, Horn, S D
• Format: Article
• Language: English
• Subjects: Diagnosis; Humans; Interprofessional Relations; Nurse Practitioners; Physician Assistants; Physicians; Therapeutics
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.68.1.44

Six primary care practices which utilize both physician and non-physician practitioner types were studied to measure differences between practitioner types in the care of patients. By chart review 1,369 patient-practitioner encounters were examined. Physicians identified less symptoms and signs in their patients and prescribed less non-drug therapies than did non-physicians. Likewise, at follow-up visits, physicians tended to document less follow-up of these types of problems and therapies than non-physicians. When examining the interaction between practitioners, the highest rates of follow-up of all types of problems and therapies were found when the same practitioner saw the patient at two successive visits to the same clinic. When a physician saw a patient following a previous visit to a nurse practitioner, there was a significant drop-off in the follow-up rate of problems and therapies. However, when a nurse practitioner saw the patient following a previous visit to a physician, the drop-off in follow-up rates was not as striking. These findings indicate that the skills of physician and nonphysician practitioners are potentially complementary. However, this potential is not fully exploited, particularly by physicians.