Nurse practitioners (NPs) and physician assistants (PAs) play an important role in our healthcare system. However, because they do not have the same extensive education and training as a physician, physicians should always be involved to oversee care and to lead the medical team.
Unfortunately, in some facilities patients are receiving care only by non-physician practitioners working without any physician involvement. A lack of physician oversight can lead to missed diagnoses and medical errors.
As a patient, you should have the right to physician-led care.
Is there a physician overseeing my care?
A nurse practitioner (NP) or physician assistant (PA) should always have access to a supervising or “collaborating” physician. Ideally, this physician would be available on-site. When this is not possible, the physician should be easily accessible by telephone for consultation. Ask your clinician how often they call their collaborating physician to find out how closely they work together.
Some states now allow NPs and PAs to treat patients without a formal collaborating physician. You need to know if this is the case.
You should always know if a physician is involved in your care or can be easily involved in your care.
New Office Visits
Your initial visit at a new primary care or specialty office should always involve evaluation by a physician. If you are seen by a NP or PA, the physician should also come to see you, ask additional questions, possibly examine you, and confirm the next steps for your care. When a referral is being made to another physician, ensure that your physician has deemed that referral to be necessary.
Return Office Visits
If you have been to the office before and already have met the physician, seeing an NP or PA may be appropriate. NPs and PAs can ensure that you are on track for the plan you, your physician, and your NP/PA developed at prior visits. However, if a new problem arises or it has been a couple of visits since you last saw your physician, consider asking to see the physician.
At the ER or Urgent Care
Many emergency departments and urgent care facilities no longer have a physician available on site.
An NP or PA can be a real asset to the medical team when working in the appropriate role and in close collaboration with a supervising physician. Ask your clinicians about their training and supervising relationships. Your clinician should welcome these questions and make every effort to ensure that you receive the best possible care.