The number of nurse practitioners (NPs) and physician assistants (PAs) continues to rise in the U.S., and the associations representing them continue to push state legislatures for permission to practice without physicians’ supervision.

Scope of practice expansion advocates argue that these nonphysician providers are just as good as physicians. But evidence from the past half century fails to provide conclusive evidence that nurse practitioners and physician assistants can provide safe and effective medical care without physician oversight, according to AMA member and Florida family physician Rebekah Bernard, MD.

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