New health professions after a decade and a half: delegation, productivity and costs in primary care.

Though knowledge about physician's assistants and nurse practitioners is far from conclusive, these new health practitioners (NHPs) appear to perform a large percentage of primary care services at a high level of quality and productivity. Moreover, the gap between the physician/NHP substitution ratio and the NHP/physician cost ratio seems wide enough to assure cost savings when NHPs are used well.

PIP: Although knowledge about physicians' assistants and nurse practitioners is far from conclusive, review of the literature indicates that these new health practitioners (NHPs) appear to perform a large percentage of primary care services at a high level of productivity in the U.S. Moreover, the gap between the physician/NHP substitution ratio and the NHP/physician cost ratio seems wide enough to assure cost savings when NHPs are used well.

Defensibility of new health professionals at law: a speculative paper.

The future of physician's assistants and nurse practitioners will be shaped at least in part by whether, and on what terms, they are defensible at law. This paper explores the way in which the principles of tort law might define primary and secondary liability for these new health professionals. Among the issues discussed in substantial detail are whether a separate standard of care is appropriate, whether the new professionals might function as independent contractors, and the importance of striking an adequate social balance between improved access to health care or cost containment on the one hand and malpractice deterrence or redressment on the other.