Comparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and Physicians

Letters3 January 2017Comparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and PhysiciansJohn N. Mafi, MD, MPH and Bruce E. Landon, MD, MBA, MScJohn N. Mafi, MD, MPHFrom David Geffen School of Medicine at UCLA, Los Angeles, California; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this author and Bruce E. Landon, MD, MBA, MScFrom David Geffen School of Medicine at UCLA, Los Angeles, California; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0552 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Claret and colleagues that ED overcrowding is an important public health concern and that integrating APCs into the clinical workflow in the ED may offer a solution. Although most research comparing APCs with physicians has focused on the primary care setting, few high-quality studies that we are aware of have evaluated the quality and efficiency of emergency care provided by APCs. One systematic review (that included 3 randomized trials) found that adding a nurse practitioner to see patients in the ED with minor conditions improved patient satisfaction and wait times with a negligible effect ...References1. Carter AJ, Chochinov AH. A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department. CJEM. 2007;9:286-95. [PMID: 17626694] CrossrefMedlineGoogle Scholar2. Doan Q, Sabhaney V, Kissoon N, Sheps S, Singer J. A systematic review: the role and impact of the physician assistant in the emergency department. Emerg Med Australas. 2011;23:7-15. [PMID: 21284809] doi:10.1111/j.1742-6723.2010.01368.x CrossrefMedlineGoogle Scholar3. Tsai CL, Sullivan AF, Ginde AA, Camargo CA. Quality of emergency care provided by physician assistants and nurse practitioners in acute asthma. Am J Emerg Med. 2010;28:485-91. [PMID: 20466230] doi:10.1016/j.ajem.2009.01.041 CrossrefMedlineGoogle Scholar4. Mehrotra A, Liu H, Adams JL, Wang MC, Lave JR, Thygeson NM, et al. Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. Ann Intern Med. 2009;151:321-8. [PMID: 19721020] LinkGoogle Scholar5. Carter BL, Rogers M, Daly J, Zheng S, James PA. The potency of team-based care interventions for hypertension: a meta-analysis. Arch Intern Med. 2009;169:1748-55. [PMID: 19858431] doi:10.1001/archinternmed.2009.316 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From David Geffen School of Medicine at UCLA, Los Angeles, California; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2152. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and Physicians John N. Mafi , Christina C. Wee , Roger B. Davis , and Bruce E. Landon Comparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and Physicians Pierre-Géraud Claret , Xavier Bobbia , and Jean Emmanuel de La Coussaye Comparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and Physicians Michael Kelley Metrics Cited byThe primary spine practitioner as a new role in healthcare systems in North AmericaClinician Attitudes and Beliefs Associated with More Aggressive Diagnostic TestingPatient Outcomes in a Pediatric Hospital Medicine Service Staffed With Physicians and Advanced Practice ProvidersScope-of-Practice Laws and Patient Safety: Evidence from the Opioid Crisis 3 January 2017Volume 166, Issue 1Page: 77KeywordsDisclosureHealth care qualityNursesObservational studiesPatientsPrevention, policy, and public healthPrimary careRandomized trialsResearch quality assessmentSystematic reviews ePublished: 3 January 2017 Issue Published: 3 January 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...