Quality of Care Provided by Physician's Extenders in Air Force Primary Medicine Clinics

by George A. Goldberg, David G. Jolly

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Evaluates the quality of care of physician extenders (PEs) (23 physician assistants and seven primary care nurse practitioners) in Air Force primary medicine clinics, as part of an evaluation of PEs assuming care formerly provided by physicians. PEs performed at least as well as M.D.s on 25 out of 28 nonredundant process-of-care criteria. Nurse practitioners met the M.D. standard on 14 of 19 criteria. No major differences were found in PEs' use of ancillary services (laboratory and X-ray) or orders for further care when controlling for case-mix. As expected, PEs consulted M.D.s infrequently, but more often for serious complaints and at rates similar to those found in other PE studies. The study concludes that the Air Force can deliver the same quality of care when PEs treat a sizable proportion of patients formerly treated by M.D.s.

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