Does familiarity breed respect? Physician attitudes toward nurse practitioners in a medically underserved state

An evolving primary care environment underscores the importance of physician and nurse practitioner (NP) interactions. We analyze how physician characteristics and close working relationships (presence of NPs in practice) influence physicians' attitudes toward NPs.

Bivariate analyses of 2007-2008 Mississippi Physician Workforce Study survey data (response rate 23.3%) identified Mississippi physician characteristics associated with having NPs in practices and discrete NP-attitudinal items. Generalized physician attitudes toward NPs were modeled using multivariate regression.

Generalists, physicians in public sector employment and physicians in larger practices are more likely to work in practices that also include NPs. Physicians working with NPs are somewhat younger than those who do not. Regression analysis indicates that male physicians had less-positive attitudes toward NPs, while physicians who practice alongside NPs and who have been in practice longer have the most positive generalized attitudes toward NPs.

Physicians who work in the same practice with NPs have more positive attitudes toward them. However, regardless of work arrangements, MS physicians are reluctant for NPs to practice independently. Physicians with early collaborative training with NPs may have more positive attitudes, but even such exposure will not necessarily lead physicians to support NPs' independent practice.