Why Patients Love Physician Extenders

By Perry, Kristie | Medical Economics, August 21, 1995 | Go to article overview

Why Patients Love Physician Extenders


Perry, Kristie, Medical Economics


You've heard this before: Not only do physician extenders allow your practice to see more patients, but patients are enthusiastic about them. If you have any doubts, our survey should dispel them.

Nearly one quarter of respondents said their doctor visits are sometimes handled by a non-physician (a physician assistant, nurse practitioner, or nurse midwife), and nearly nine in 10 of those said they're very or somewhat satisfied with the care they receive. That's nearly as great a vote of confidence as the 97 percent of patients who said they're satisfied with their doctor's medical know-how.

The resounding acceptance of these midlevel practitioners is good news. With salaries at 40 to 50 percent of the typical primary-care doctor's, physician extenders are an economical solution to managed care's challenge -- to treat more patients for less money. In fee-for-service practices, extenders free doctors to handle the more complicated -- and remunerative -- tasks.

Across the country, patients praised extenders for contributing to quicker appointments and for being good listeners. "I'm a busy person," said a Wisconsin executive. "Sometimes, agreeing to see a PA is what it takes to get in." Said this 34-year-old publishing executive of her NP: "She spends more time than the M.D. and is better at listening, explaining, and providing additional resources."

Some also praised extenders for lowering the cost of a routine visit. An Illinois accountant, after noting that things like colds, flu, and stitches don't really need a doctor's attention, added, "Plus, seeing the nurse is cheaper." In some cases, it is. Some practices charge less for being seen by the assistant, but others charge the same fee regardless of who sees the patient.

Naturally, however, that disgruntles those patients who consider treatment from an extender tantamount to a rip-off. A California laborer groused: "If I'm paying M.D. rates, I'd better get to see my M.D." A 42-year-old man from Pennsylvania was even more pointed, equating extender care with "bait and switch tactics": "Although many PAs and nurses are competent, when I make an appointment to see a doctor, that's who I expect to see," he said. "They have more experience."

That aside, respondents voiced confidence that extenders are competent and understand their limitations. "If they don't know what they're doing, they don't guess; they go get the doctor," observed a seamstress from Arkansas.

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