Assistants to primary physicians in California

Area of Science:

• Healthcare policy
• Primary care
• Health workforce development

Background:

• The role of mid-level practitioners in healthcare is established, not experimental.
• Nurse practitioners (NPs) and physician assistants (PAs) are integral to primary care delivery in California.
• Existing legislation has supported NP and PA training and practice.

Purpose of the Study:

• To evaluate the established role of NPs and PAs in California's primary healthcare system.
• To identify legislative needs for optimal utilization of these professionals.
• To discuss the evolving landscape of NP and PA professional roles and responsibilities.

Main Methods:

• Analysis of California legislation (AB2109, AB1503) impacting mid-level practitioners.
• Review of professional role evolution, including issues of sex and delegation.
• Consideration of the role of national accreditation and certification bodies.

Main Results:

• NPs and PAs have demonstrated a necessary and viable role in primary healthcare.
• Legislation has facilitated their training and function, but further comprehensive laws are required.
• National agencies are increasingly involved in program approval and graduate certification.

Conclusions:

• The mid-level practitioner movement is a proven component of primary healthcare.
• Optimizing the utilization of NPs and PAs requires further legislative action.
• Ongoing resolution of professional role issues is contributing to a more equitable, patient-centered healthcare system.