Doctors are in increasingly short supply these days, so it’s not uncommon for patients to spend more time with physician assistants (PAs) and nurse practitioners (NPs) than their actual MD. This trend has sparked controversy among physicians and patients alike. While so-called “mid-level providers” like NPs and PAs are undoubtedly essential for filling gaps in the healthcare system, there is some concern that these men and women are tasked with responsibilities that are beyond the scope of their training and expertise.

Angela Golden, DNP, immediate past president of the American Association of Nurse Practitioners, doesn’t see this as an issue. “There is a healthcare provider shortage all over the United States,” she points out. “Since 80 percent of nurse practitioners practice in primary care, we are an excellent source for healthcare.”

While this may be true for general medical care, others are concerned that doctors delegate too many specialized tasks to mid-level providers. NPs and PAs are trained in using and interpreting a wide range of diagnostic tools to diagnose and treat acute, episodic and chronic conditions, therefore it can be difficult to ascertain where their expertise begins and ends.

Understanding The Differences Between Healthcare Professionals

First, it’s essential to understand what separates a mid-level provider from a full-blown physician. Just because a healthcare worker doesn’t have “MD” or “DO” following their name doesn’t mean they are not capable of offering quality care, according to Golden. NPs, for example, are typically required to attend a four-year nursing program, obtain a doctoral or master’s degree, and go through a national certification process. A great deal of real world experience is gathered throughout this process, and they also undergo periodic peer reviews and participate in continuing education courses. PAs have similar requirements.

As a result, NPs and PAs can execute a diverse array of medical care tasks. They can order and conduct diagnostic tests and lab work, perform in-office procedures, prescribe medications, and diagnose and treat health conditions like high blood pressure, injuries, infections and diabetes. Depending on the regulations of the state in which they’re practicing, mid-level providers either work under the direction of or in collaboration with a physician.

By Anne-Marie Botek