Literature DB >> 9729991

Roles of nonphysician clinicians as autonomous providers of patient care.

R A Cooper1, T Henderson, C L Dietrich.   

Abstract

Studies were undertaken to assess the practice prerogatives of nonphysician clinicians (NPCs) in 10 disciplines that, collectively, are the major nonphysician contributors to the delivery of medical and surgical services. These disciplines include nurse practitioners, physician assistants, nurse-midwives, chiropractors, acupuncturists, naturopaths, optometrists, podiatrists, nurse anesthetists, and clinical nurse specialists. Marked differences were found in the practice prerogatives that states granted NPCs in the various disciplines. For most disciplines, the magnitude of their prerogatives correlated with the numbers of NPCs practicing in each state. At their maximal levels, state practice prerogatives authorized a high degree of autonomy and a broad range of authority to provide discrete levels of uncomplicated primary and specialty care. The recent growth in these prerogatives is fostering new opportunities for NPCs; however, it also is creating a pluralism that has the potential to further fragment the US health care system. It is time for regulatory integration and professional collaboration so that a health care workforce that includes a diversity of disciplines can be assured of providing a coherent set of patient care services in the future.

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Year:  1998        PMID: 9729991     DOI: 10.1001/jama.280.9.795

Source DB:  PubMed          Journal:  JAMA        ISSN: 0098-7484            Impact factor:   56.272


  23 in total

1.  The changing perceptions of junior medical students about the current U.S. health care system after a seminar series.

Authors:  F W Markham; H K Sawhney; J A Butler; J J Diamond
Journal:  J Community Health       Date:  2001-10

Review 2.  Chiropractic in the United States: trends and issues.

Authors:  Richard A Cooper; Heather J McKee
Journal:  Milbank Q       Date:  2003       Impact factor: 4.911

3.  Chiropractic health care in health professional shortage areas in the United States.

Authors:  Monica Smith; Lynne Carber
Journal:  Am J Public Health       Date:  2002-12       Impact factor: 9.308

4.  Economic expansion is a major determinant of physician supply and utilization.

Authors:  Richard A Cooper; Thomas E Getzen; Prakash Laud
Journal:  Health Serv Res       Date:  2003-04       Impact factor: 3.402

5.  Physician assistants in the United States.

Authors:  David E Mittman; James F Cawley; William H Fenn
Journal:  BMJ       Date:  2002-08-31

6.  Mortality and physician supply: does region hold the key to the paradox?

Authors:  Thomas C Ricketts; George M Holmes
Journal:  Health Serv Res       Date:  2007-12       Impact factor: 3.402

7.  The present state and future direction of primary care: a qualitative study of GPs' views.

Authors:  Helen Lester; Stephen M Campbell; Ruth McDonald
Journal:  Br J Gen Pract       Date:  2009-12       Impact factor: 5.386

8.  The interventional radiology clinic: what you need to know.

Authors:  Gary P Siskin; Sandeep Bagla; Gail E Sansivero; Nancy L Mitchell
Journal:  Semin Intervent Radiol       Date:  2005-03       Impact factor: 1.513

9.  Treatment decisions for complex patients: differences between primary care physicians and midlevel providers.

Authors:  Usha Subramanian; Eve A Kerr; Mandi L Klamerus; Brian J Zikmund-Fisher; Robert G Holleman; Timothy P Hofer
Journal:  Am J Manag Care       Date:  2009-06       Impact factor: 2.229

10.  Physician assistants and nurse practitioners as a usual source of care.

Authors:  Christine M Everett; Jessica R Schumacher; Alexandra Wright; Maureen A Smith
Journal:  J Rural Health       Date:  2009       Impact factor: 4.333

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