More specialty practices use NPs and PAs beyond routine follow-up care

Incorporating NPs and PAs could improve access to patients, researchers noted.

Specialty practices are using nonphysician providers to see patients and not just for routine follow-up care, according to a new study.

Specialty practices have increasingly used nurse practitioners (NP) and physician assistants (PA) over the past decade, but they are not only seeing patients for return and routine visits, according to a research letter in JAMA Internal Medicine. These nonphysician providers are increasingly seeing new patients and those there for acute visits, researchers said.

Given the limited supply of specialist physicians, the researchers said incorporating NPs and PAs could improve access to patients. They hypothesized that these nonphysicians would be providing care primarily for routine follow-up, but their review of a national sample of visits from 2001 to 2013 found that was not the case.


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There was also an increase in the number of patients who saw an NP or PA without also seeing a doctor.  

However, growth of NPs and PAs in specialist care has slowed in recent years and also remains a small proportion of overall specialist visits, the study found.

RELATED: Doctor’s frustration: She refers patients to specialists and they see nonphysicians

The increased use of nonphysicians in specialty practices has drawn the ire of some physicians. When she refers patients to a specialist, she wants them to be seen by a physician, but that's not the case, Kimberly Becher, M.D., who practices at a rural federally qualified health center in Clay County, West Virginia, recently noted. 

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