Delegation potential of primary care visits by physician assistants, medex and primex.

In order to determine the appropriate level of any support for primary care new health practitioners (NHP) programs, an estimate needs to be made of the demand for these programs; the degree to which primary care NHPs can substitute for physicians' services will have an impact on this demand. Using community-wide data on the nature and volume of care provided by physicians in their ambulatory practices, the authors estimated the proportion of care that three common types of primary care NHPs could handle: Primex nurse practitioners, 2-year physician assistants and Medex. Panelists with expert knowledge of each NHP type assessed primary care abstracts to determine if the NHPs could have handled all, some or none of the visit. Overall, the three groups considered collectively were deemed capable of assuming all or some responsibility for a large proportion of primary care--92 per cent. Differences among NHP type were found with regard to the morbidity each could handle, with 2-year physician assistants capable of handling the broadest spectrum of care. Community-wide estimates made regarding the number of NHPs employable by physician specialty showed general practitioners and pediatricians having the practice volume and type of morbidity sufficient to most easily employ NHPs.