The number of office visits was higher for practices with NPs or PAs. And the use of laboratory and radiology tests was also higher: 81% vs. 62% and 20% vs. 14% respectively. According to the authors, “This [finding] raises concerns that NPs and PAs may not practice as efficiently as rheumatologists.”
Although the researchers note that the study’s sample size is limited, they conclude their work by saying, “These findings support the [Affordable Care Act] provisions on an expanding role for [nurse practitioners] or [physician assistants].” They also call for more research in other medical specialties, including randomized experiments, to help clarify the value of NPs and PAs. Additionally, they recommend more in-depth training and recruitment of NPs and PAs for rheumatology.
Solomon DH, Fraenke L, Lu B, Brown E, Tsao P, Losina E, Katz JN, Bitton A. Comparison of care provided in practices with nurse practitioners and physician assistants versus subspecialist physicians only: A cohort study of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2015 Jun 19. doi: 10.1002/acr.22643. [Epub ahead of print]