The Substitution of Physician Assistants and Nurse Practitioners for Physician Residents in Teaching Hospitals

This study documents features of clinical departments in teaching hospitals that are using physician assistants (PAs) and nurse practitioners (NPs) to perform some tasks previously done by medical or surgical residents. More than 60 percent of teaching hospital medical directors surveyed reported experience with substitution in their hospitals. The experience overall appears to be positive; one-third of the departments are planning to increase the number of PAs and NPs they use. The results imply that some of the services lost in house-staff reductions called for in many physician workforce reform proposals could be provided by alternative health professionals.