Question

The use of non-physician clinicians mainly nurse practitioners and physician assistants in ambulatory care is increasing. Should these two types of clinicians be allowed to practice independently or should they remain under the supervision of a board certified physician. What are the strengths and pitfalls of each road.

Answer 1

Today's healthcare industry is growing steadily with increasing number of patients with various illnesses. and ,it is a worldwide scenario that there are issues with physician to patient ratio and critical attrition rate. To tackle this issues, use of non-physician clinicians mainly nurse practitioners and physician assistants were considered in ambulatory care settings. Any remedial solution towards an issue will have its two sides with advantages and disadvantages.

Strengths of using a non-physician professionals for patient care are as follows;

- When non-physicians are chosen instead of physicians ,this can increase the patient's accessibility at any point of time when the physicians are unavailable

- This can result in increased productivity by the good influx of patients towards the hospital as there is easy availability of appointments

- The waiting time at the hospital is reduced as they can be treated by the non-physician professionals can be ready to serve the patients

- This also helps in elevating the patient satisfaction index

- The services can be delivered with more compassion and quality

- NPs/PAs are well trained to deliver wide range of clinical care and able to assess the patient's health status by conducting clincial evaluation and interviews

- They also can interpret the investigations value and recommend therapeutic plans as per the need of the clients

- They are also knowledgeable in taking ward rounds,and handles emergency call and telecommunication techniques

- The documentation would be with clarity and completeness

- The salary earned by the non-physicians are comparatively lesser than the physicians ,thus this can yield revenue

Pitfalls in using non-physicians in place of physicians are as follows;

- Non-clinical physicians course guidelines are not standardized to practice the clinical deliveries

- Even though, they are experts ,certain procedures cannot be performed by them

- Delivering emergency care services with effectiveness is questionable

- There could be many patients and doctors who are uncomfortable getting treated by the non-clinical physicians with the same cost

- At times, treatment given by NPs/PAs are not accepted by many organisations on statutory basis

Hence, it is very much possible to deliver clinical care to clients at many instances by non-clinical physicians but this can be made efficient with the help of supervision from a board certified physician.