New Kinds of Primary Care Providers
Over the years primary care has evolved and there are now four kinds of primary care providers who work as a team in providing patient care: Primary Care Physician (PCP), Nurse Practitioner (NP), Physician Assistant (PA), and Hospitalist.
Primary Care Physician (PCP)
A physician who has completed 4 years of medical school, one year of internship and two years of residency (usually in either internal medicine, family medicine or pediatrics) and sometimes fellowship or subspecialty training.
The Reason
A PCP is responsible for a patient’s care across all locations and care providers. They deliver primary care and coordinate specialty care. The PCP remains in close communication with Hospitalists and consultants when patients are hospitalized.
The Benefit
PCPs know their patients better than anyone else in the healthcare system. They are the keeper of the healthcare record that documents their patient’s healthcare status. They coordinate care between providers and advise patients on healthcare decisions, where to go for care, what care they need and when they need it.
Nurse Practitioner (NP)
A registered nurse who has also completed graduate-level medical education. For most, this has meant getting a master’s degree, but more and more NPs are advancing to a Doctor of Nursing Practice, which can take two to four more years of study.
The Reason
Like PAs, nurse practitioners helped fill the PCP shortage in the mid-‘60s. NPs can function as primary care providers, with or without physician supervision.
The Benefit
NP’s can perform all the functions of a PA as described. Studies have found that NPs can provide care that matches and at times improves on that of doctors while still being cost-effective: NPs emphasize prevention and spend an average of 21 minutes with a patient, longer than a typical doctor visit.
Physician Assistant (PA)
A licensed clinician who has completed at least a two-year accredited program and practices under the supervision of a physician. PAs are not required to complete internships or residencies; many focus their studies on primary care medicine.
The Reason
The PA role began in the mid-1960s in response to a shortage of PCPs in underserved and rural areas. One doctor’s office can employ several physician assistants to act as principal care providers, per the guidance of the supervising physician.
The Benefit
Physician assistants are often available for appointments when physicians aren’t. This care can include conducting physical exams, diagnosing and treating illnesses, ordering and interpreting tests, counseling on preventive care, writing prescriptions, and assisting in surgery.
Hospitalist
A physician who manages a patient’s care in the hospital until discharge. Most hospitalists have a Doctor of Medicine or a Doctor of Osteopathic Medicine degree; the majority are trained in internal medicine, pediatrics and sometimes specialty care.
The Reason
A hospitalist is the in-hospital point person to oversee the care a patient receives from nurses, surgeons, and specialists. They remain in close contact with a patient’s PCP to assure continuity of care between outpatient and inpatient care.
The Benefit
Hospitalists are available around the clock, and are intimately familiar with the hospital environment. This can translate to a reduction in length of stay—and expense—by an average of 15 percent. Research shows that hospitalists provide a standard of care that matches or surpasses that provided by PCPs. In fact, a few studies indicate lower mortality and readmission rates in hospitalist programs.
