However, concern over the shortage of primary care physicians in underserved areas and the emphasis on cost control in managed care has focused and intensified industry, academic and third party payors' attention to the roles of PEs in both private medical practices and managed care settings. Economic Rationales A review of the developing literature and statistics in this area offers sound economic rationales for incorporating PEs into many medical practices. PEs can be cost-effective in both private practice and managed care settings. PEs can also actually increase physician productivity in some instances. A recent AMA Center for Health Policy Research study reported that solo physicians who employ non-physician providers see more patients per hour, per week and per year and report higher net incomes than those who do not.
Patients are generally pleased with the quality of care delivered by PEs.
For example, in January 1996, MGMA published the results of an information exchange survey regarding PAs which showed that 429 out of 663 practices surveyed employed PAs and that a higher percentage were satisfied with their performance. Some PEs can be utilized efficiently and effectively in both primary care and specialty practices. The range of services a particular PE can provide will depend upon the scope of her license under state laws, as well as the needs of the practice and the physician's views of the PE role. In addition to their directly billable services, these PEs can increasingly be utilized to provide non-billable services, thereby freeing the physicians for the performance of remunerative activities. Organized medicine has begun to advocate a multi-disciplinary team approach to the delivery of health care to assure the public maximum access and minimum cost for health care services for the public.