Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states.

Moldestad M, Greene PA, Sayre GG, Neely EL, Sulc CA, Sales AE, Reddy A, Wong ES, Liu CF. Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states. Journal of Advanced Nursing. 2020 Nov 1; 76(11):3092-3103.

Related HSR&D Project(s)

• IIR 14-054 – Optimizing the Value of Primary Care Delivered by Nurse Practitioners

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Abstract:

AIMS: To understand patients'' and providers'' perceptions of primary care delivered by nurse practitioners (NPs) in the Veterans Affairs Healthcare System. DESIGN: Qualitative exploratory study (in convergent mixed-methods design). METHODS: Semi-structured interviews in 2016 with primary care providers and patients from facilities in states with full and restricted practice authority for NPs. Patient sample based on reassignment to: (a) a NP; or (b) a different physician following an established physician relationship. Data were analysed using content analysis. RESULTS: We interviewed 28 patients, 17 physicians and 14 NPs. We found: (a) NPs provided more holistic care than physicians; (b) patients were satisfied with NPs; and (c) providers'' professional experience outweighed provider type. CONCLUSIONS: Patients'' preferences for NPs (compared with prior physicians) contributed to perceptions of patient centredness. Similarities in providers'' perceptions suggest NPs and physicians are both viable providers for primary care. IMPACT: Nurse Practitioners (NPs): practice authority Veterans Affairs Health care: nurse practitioners will continue to be a viable resource for primary care delivery United States Health care: challenges notions patients may not be satisfied with care provided by NPs and supports expanding their use to provide much-needed access to primary care services; expanding Full Practice Authority would allow states to provide acceptable primary care without diminishing patient or provider experiences.