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Who's Who in Your Doctor's Office?

How physician assistants and nurse practitioners at your doctor's office bridge the primary care gap

Will a nurse practitioner or physician’s assistant provide care as well as your doctor?  When to see these physician extenders?

How physician assistants and nurse practitioners at your doctor's office bridge the primary care gap

The cough you’ve had for more than a week isn’t getting any better, and your throat is starting to ache. But when you call your doctor’s office for an appointment, the news isn’t good. “The doctor doesn’t have any open appointments for three weeks. Would you like to see our nurse practitioner instead? We can get you in tomorrow morning.”

Just what is a nurse practitioner anyway — and can he or she really care for you as well as your doctor?

More patients, fewer doctors, new health care team members

In the past few years, demand has grown for primary health care services at the same time fewer graduating medical students have opted to pursue the traditional “primary care” specialties — family or internal medicine.

As the population ages, people require more primary care. And with the rolls of the newly insured expected to grow this year, as the Affordable Care Act of 2010 begins to offer greater access to health insurance, “physician extenders” are a key to helping doctors meet the growing demand.

“Primary care physicians in some areas are stretched to capacity today,” says G. Ryan Dominguez, MD, a Scripps family medicine provider. “In the past ten or fifteen years, many physicians have added nurse practitioners and physician assistants to the team in their medical practices.”

Unlike nurses and medical assistants, who commonly complete pre-appointment tasks like weighing patients and taking their temperature and blood pressure, nurse practitioners (NPs) and physician assistants (PAs) can actually examine and treat patients.

What can physician extenders do?

Both NPs and PAs are medical professionals who have completed specific educational and training programs that qualify them to provide many of the same general care services as physicians, such as:

  • Conducting physical exams
  • Diagnosing and treating common routine and acute illnesses
  • Ordering and interpreting laboratory tests and X-ray
  • Writing prescriptions

Who should you see?

So how do you know whether you need to see the doctor or a mid-level provider?

When you are ill and faced with the choice of seeing an NP or PA soon or waiting several weeks for the physician, it’s generally better to get in and be seen. For coughs, earaches, rashes and other “routine” ailments, it’s fine to see a mid-level person.

Even if your problem does turn out to be something more serious, both NPs and PAs work under the supervision of your physician and will discuss your care with him or her. Most of the time, the physician will be in the office during your appointment and can be consulted right away. If not, the PA or NP will make sure he or she is aware of your condition and proper actions are taken to provide the care you need.

If you are going in for ongoing evaluation or treatment for a chronic condition, on the other hand, and have no urgent health concerns, you may want to hold out for an open appointment with your physician.