Nonphysician providers in hospital medicine: Not so fast

Ford and Britting's 1 editorial in this month's Journal of Hospital Medicine raises important questions concerning the use of nonphysician providers in hospital medicine.They focus primarily on the use of mid-level providers (MLPs), namely physician-assistants (PAs) and nurse practitioners (NPs), as a potential solution to the current physician workforce shortages in our field.While we acknowledge the challenges of meeting workforce needs, we also believe that much is unknown about the optimal use of MLPs on inpatient general medicine services and it is premature to tout MLPs as the solution to hospital medicine staffing problems.This is especially true in those hospitals where hospitalists care for complex, general medical patients with a wide variety of medical conditions, a trend that is especially common in academic medical centers. 2 This article discusses the current literature, our own experiences with MLPs, and suggests some future initiatives that might help better integrate MLPs into hospital medicine.