Nurse Practitioners and Physicians Assistants Handle Same Acute Care Activities as Doctors

Integration of mid-level practitioners into acute care hospitals

In 1995 and 1996, the University of Pittsburgh School of Nursing compared the activities of midlevel practitioners, such as nurse practitioners and physician's assistants, with the activities of resident physicians.

The project was part of the Robert Wood Johnson Foundation (RWJF) national program Generalist Provider Research Initiative.

Key Findings

  • The researchers reported these key results in the American Journal of Critical Care:

    • Physicians scored significantly higher than midlevel practitioners on the number of hours worked and number of patients cared for.
    • Midlevel practitioners scored significantly higher than physicians in discussing the patient with a registered nurse and time spent interacting with the patient's family.
    • There were no significant differences between midlevel practitioners and physicians in seven clinical outcomes measured, including length of stay and in-hospital mortality.
    • Physicians cared for more of the older, sicker patients.