Neither the number of FTE physicians nor the use of
nonphysician providers is associated with any of the screening or monitoring measures.
In a state by state survey conducted in 1992, the Physician Payment Review Commission reported that many state Medicaid programs were not covering
nonphysician providers to the extent those states' practice acts permitted.
Health services research related to the current use and usefulness of
nonphysician providers has focused on physician assistants (PAs) and nurse practitioners, 2 of the largest groups of such providers.
Efforts to provide medical information to the non-academically based provider are increasing in numbers; studies such as Ellen Hall's (1995) indicate that
nonphysician providers, such as physical therapists, have an increased need for medical information as they branch out from hospital-based practices to private practices.
Some experts have raised concerns about an oversupply of specialists who rely heavily on government funding for training, while, at the same time, licensure laws and Federal reimbursement regulations restrict
nonphysician providers from entering the health care marketplace.
If we had the missing information [about how nurse practitioners provide care], perhaps we could argue for policies that would support the professional autonomy of
nonphysician providers and broaden the scope of their practice without reinforcing the sexual division of labor market.
Looking at the various models now developing, it would seem that future integrated delivery systems will utilize both PCPS and specialists, but with strong augmentation from a diverse assortment of other health care professionals, including
nonphysician providers, educators, and administrators.
universal coverage, preventive health care, cost containment through managed care, extensive use of
nonphysician providers, and an emphasis on what's medically effective for our citizens" (Washington Post, 20 March 1993).
And such is the case as well for
nonphysician providers --we are not in this alone.
Proposed changes to regulations implementing the Stark Law could make it easier for physicians to hire new
nonphysician providers (NPP) to provide primary care.
Increasingly, policy needs to reflect the important role of
nonphysician providers, including pharmacists," says the NACDS paper.
