Differences in the number of services provided by nurse practitioners and physicians during primary care visits

Nurs Outlook. 2021 Sep-Oct;69(5):886-891. doi: 10.1016/j.outlook.2021.04.003. Epub 2021 Jun 4.


Background: Due to differential training, nurse practitioners (NPs) and physicians may provide different quantities of services to patients.

Purpose: To assess differences in the number of laboratory, imagining, and procedural services provided by primary care NPs and physicians.

Methods: Secondary analysis of 2012-2016 National Ambulatory Medical Care Survey (NAMCS), containing 308 NP-only and 73,099 physician-only patient visits, using multivariable regression and propensity score techniques.

Findings: On average, primary care visits with NPs versus physicians were associated with 0.521 fewer laboratory (95% CI -0.849, -0.192), and 0.078 fewer imaging services (95% CI -0.103,-0.052). Visits for routine and preventive care with NPs versus physicians were associated with 1.345 fewer laboratory (95% CI -2.037,-0.654), and 0.086 fewer imaging services (95% CI -0.118,-0.054) on average. Primary care visits for new problems with NPs versus physicians were associated with 0.051 fewer imaging services (95% CI -0.094,-0.007) on average.

Discussion: NPs provide fewer laboratory and imaging services than physicians during primary care visits.

Keywords: Ambulatory Care; Nurse practitioners; Physicians; Practice patterns; Primary Care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Facilities and Services Utilization
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Nurse Practitioners*
  • Office Visits / statistics & numerical data*
  • Physicians, Primary Care*
  • Practice Patterns, Nurses' / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*