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Half of office-based U.S. physicians work with 'physician extenders'


About half of all office-based U.S. physicians were in practices employing so-called “physician extenders,” with primary care physicians being more likely to work with them than medical specialists, according to a government report.

According to the National Center for Health Statistics, in 2009 49.1% of office-based physicians were in practices that used nurse practitioners (NPs), certified nurse midwives (CNMs), or physician assistants (PAs).

NPs, CNMs, or PAs were more likely to be in primary care, and larger and/or multispecialty practices. They were less likely to work with older physicians (as opposed to middle-aged physicians) or in smaller, single-specialty practices.

Physician extenders also tended to be in practices with higher revenues from Medicaid and a lower proportion of Medicare patients, according to the report, which was based on the 2009 National Ambulatory Care Survey.

Researchers said they conducted the study because, “The expansion of health insurance coverage through healthcare reform, along with the aging of the population, are expected to strain the capacity for providing healthcare. Projections of the future physician workforce predict declines in the supply of physicians and decreasing physician work hours for primary care. An expansion of care delivered by NPs, CNMs, and PAs is often cited as a solution to the predicted surge in demand for healthcare services and calls for an examination of current reliance on these providers.”

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