Roles of nonphysician clinicians as autonomous providers of patient care

被引:118
作者
Cooper, RA
Henderson, T
Dietrich, CL
机构
[1] Med Coll Wisconsin, Hlth Policy Inst, Milwaukee, WI 53226 USA
[2] Natl Conf State Legislatures, Washington, DC USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1998年 / 280卷 / 09期
关键词
D O I
10.1001/jama.280.9.795
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:795 / 802
页数:8
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