Health problems encountered by nurse practitioners and physicians

The effects of specialty, setting, and provider group on the distributions of health problems managed by nurse practitioners and physicians in obstetric-gynecology, adult medicine, pediatrics, and family practice specialties are studied. Proportional samples by clinic were drawn from a total of 39,243 patient visits made to 16 ambulatory care clinics during an 18-week period. A Patient Encounter Form was used as the instrument and the ICD-9-CM was used as the coding system. Distributions of health problems differed between nurse practitioners and physicians in each clinic. Specialty affected the distributions of health problems managed by both provider groups. Setting affected the distributions of health problems for all specialties except the distributions of health problems not related to diseases or injuries (V codes) in family practice. Provider group effects were inconclusive. Community-based settings seem especially appropriate for nurse practitioner practice.