By NextBestFitQuality concerns when non-physicians practice independently
Expanding what nurse practitioners, physician assistants, pharmacists, and dental therapists can do adds capacity, but some studies and physician groups raise concerns about over-prescribing, more referrals, and missed diagnoses.
Who's affected
- People with ongoing or specialist care needs: Expanded independent practice may expose them to missed diagnoses or over-prescribing.
None identified.
Under your mix of paths
- Shorter training for some roles
Open questions
- How should quality be measured and assured as roles expand?
Caused or worsened by these paths
This problem only matters if one of these paths is chosen.
Expanding certified midwives and freestanding birth centers raises safety concerns among physician groups.
Expanding professions' practice raises quality concerns among physician groups, and some studies find more prescribing and referrals.
Solution paths (2)
Open a path for what it fixes, what it creates or worsens, who gains and who loses, precedents, and how it connects to other paths. See all paths as a decision tree.
Publish outcome and prescribing data by clinician type; expand or restrict scope based on results.
- +Quality concerns when non-physicians practice independently
- −Takes years, or money up front, before it pays off
- −Depends on uncertain evidence or judgments
Require a set number of supervised hours before independent practice.
- +Quality concerns when non-physicians practice independently
- −Takes years, or money up front, before it pays off
- −Physician shortage, especially in primary care