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Cited by 166Nursing Roles and PracticesInterprofessional Education and CollaborationHealthcare Policy and Management

The Impact of Nonphysician Clinicians

Laurant, Miranda, Harmsen, Mirjam, Wollersheim, Hub, Grol, Richard, Faber, Marjan, Sibbald, Bonnie·2009·Medical Care Research and Review
DOI 10.1177/1077558709346277
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Abstract

Health care is changing rapidly. Unacceptable variations in service access and quality of health care and pressures to contain costs have led to the redefinition of professional roles. The roles of nonphysician clinicians (nurses, physician assistants, and pharmacists) have been extended to the medical domain. It is expected that such revision of roles will improve health care effectiveness and efficiency. The evidence suggests that nonphysician clinicians working as substitutes or supplements for physicians in defined areas of care can maintain and often improve the quality of care and outcomes for patients. The effect on health care costs is mixed, with savings dependent on the context of care and specific nature of role revision. The evidence base underpinning these conclusions is strongest for nurses with a marked paucity of research into pharmacists and physician assistants. More robust evaluative studies into role revision are needed, particularly with regard to economic impacts, before definitive conclusions can be drawn.

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69 of 69 references verified0 citation errors · 0 not checkable

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  • Many studies with strong research designs have shown nursing-intensive primary care models to be safe and effective.

    “Many studies with strong research designs have shown nursing-intensive primary care models to be safe and effective.8,11,18-26”

    From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [20]

  • The economic impact of nurse-led primary care remains less documented than its clinical quality.

    “Nevertheless, the economic impact of nurse-led primary care remains less documented than its clinical quality.9,20,23,26,42-44”

    From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [20]

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Authors
Laurant, M., Harmsen, M., Wollersheim, H., Grol, R., Faber, M., & Sibbald, B.
Affiliations
  • Radboud University Medical Center (NL)
  • University of Manchester (GB)
ORCID
Venue
Medical Care Research and Review
Publisher
SAGE Publications
Published
2009-10-30
Volume
66
Issue
6_suppl
Pages
36S-89S
ISSN
  • 1077-5587 (ISSN-L)
  • 1552-6801
DOI
10.1177/1077558709346277
OpenAlex
W2129916293
Cited by
166
References
69
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 2 · 2021: 5 · 2020: 10 · 2019: 15 · 2018: 14 · 2017: 19 · 2016: 17 · 2015: 16 · 2014: 15 · 2013: 16 · 2012: 9
FWCI
13.28
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Medical Care Research and Review (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
  • Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
non-physician clinicians, nurse practitioners, physician assistants, pharmacists, professional role expansion, health care costs, quality of care, health care access, health care delivery
MeSH terms
Cost-Benefit Analysis, Health Personnel, Health Policy, Health Services, Humans, Pharmacists, Physician's Role, Quality of Health Care

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