Veterans' perceptions of care by nurse practitioners, physician assistants, and physicians: A comparison from satisfaction surveys

PURPOSE: To examine the differences in patient satisfaction with care provided by nurse practitioners (NPs), physician assistants (PAs), and physicians in the Veterans Health Administration (VHA) system. DATA SOURCE: Secondary data was obtained from the VHA's Survey of Healthcare Experience of Patients (SHEP), a monthly survey designed to measure patient satisfaction. Descriptive statistics were calculated and categorical variables were summarized with frequency counts. CONCLUSIONS: Of the 2,164,559 surveys mailed to the veterans, 1,601,828 (response rate 64%) were returned. The study found that satisfaction scores increased by 5% when the number of NPs was increased compared to 1.8% when the number of physicians was increased and slightly increased or remained the same when the number of PAs was increased. Physician to PA/NP ratio was 7:3. IMPLICATIONS FOR PRACTICE: The VHA is the largest healthcare system and the single largest employer of NPs and PAs in the country. This study shows that a majority of the primary care clinic patients prefer to see NPs as compared with PAs and physicians. Besides clinical care, NPs focus on health promotion, disease prevention, health education, attentiveness, and counseling. Physicians and PAs should be educated on these characteristics to promote patient satisfaction and expected outcomes.