With the nation facing a severe shortage of M.D.s, particularly in the specialties our population increasingly requires, it would be folly to cut off the quality professionals who are fulfilling primary-care needs, and who allow M.D.s to pursue the careers they are best educated for.
PAs provide, extend and support medical care in every specialty. They are essential to the medical needs of this country.
The NP work force has evolved rapidly in the past six years toward doctoral education for nurses practicing in independent primary care. Although Dr. Brown may have "sadly watched these nonphysicians take over," he should look carefully at the facts. A randomized clinical trial reported in the Journal of the American Medical Association in 2000 showed the equivalence of specially educated NPs compared with MDs in primary care. That specialized training is now incorporated in doctor of nursing practice degrees, and the graduates have, since 2008, been passing a certification exam which the National Board of Medical Examiners says measures the same competencies as physician exam takers following medical school.
These nursing graduates also bring unique competence in public health, prevention and health promotion to their patients. Years of training is a poor predictor of competence. Physicians in primary care have, on average, seven years of education and residency postcollege; doctorally prepared nurses in primary care have five years.
The underpinnings necessary for specialty medical practice are part of every physician's training, even if they never pursue those paths. For nurses, education and residency for primary care are targeted from year one, and the outcome evidence shows they are doing it right.
Prof. Mary O'Neill Mudinger Via Wall Stree Journal: The Future Is Now for Physician Assistants and Nurses
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