Nurse practitioners (NPs) and physician assistants (PAs) play key roles in expanding access to primary care,, but their involvement in specialty care is not well described. Given concerns about the limited supply of specialist physicians, increasing incorporation of NPs and PAs into collaborative specialist practices could be a strategy for improving access. Prior studies described the frequency of NPs and PAs practicing in specialty practices and quantified the volume of care by NPs and PAs for surgical outpatients. However, to our knowledge, no study has described trends in specialist physician visits in which NPs and PAs provide care. We hypothesized that NPs and PAs increasingly are providing care to specialist physicians' patients, and that this growth is primarily for routine follow-up.
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