The Changing Definition of a Primary Care Provider
Authors: Anne L. Peters
Journal: Annals of Internal Medicine (2018)

Editorials18 December 2018The Changing Definition of a Primary Care ProviderAnne L. Peters, MDAnne L. Peters, MDKeck School of Medicine of the University of Southern California, Los Angeles, California (A.L.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2941 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The long-anticipated shortage of primary care physicians has arrived, and projections suggest that it will only get worse (1). Nurse practitioners (NPs) and physician assistants (PAs), 2 medical disciplines that originated in the 1960s, have been suggested as workforce members who could fill this gap. In this issue, Jackson and colleagues (2) showed that patients with diabetes who received care from NPs and PAs working within the U.S. Veterans Affairs (VA) health system had outcomes equivalent to those of patients cared for by physicians in a primary care setting. The authors included data from 568 VA primary care centers and ...References1. American Association of Medical Colleges. The complexities of physician supply and demand: projections from 2016 to 2030. 2018 Update. Accessed at https://aamc-black.global.ssl.fastly.net/production/media/filer_public/85/d7/85d7b689-f417-4ef0-97fb-ecc129836829/aamc_2018_workforce_projections_update_april_11_2018.pdf on 25 October 2018. Google Scholar2. Jackson GL, Smith VA, Edelman D, Woolson SL, Hendrix CC, Everett CM, et al. Intermediate diabetes outcomes in patients managed by physicians, nurse practitioners, or physician assistants. A cohort study. Ann Intern Med. 2018;169:825-35. doi:10.7326/M17-1987 LinkGoogle Scholar3. Laurant M, van der Biezen M, Wijers N, Watananirun K, Kontopantelis E, van Vught AJ. Nurses as substitutes for doctors in primary care. Cochrane Database Syst Rev. 2018;7:CD001271. [PMID: 30011347] doi:10.1002/14651858.CD001271.pub3 CrossrefMedlineGoogle Scholar4. American Diabetes Association. 4. Lifestyle management: standards of medical care in diabetes–2018. Diabetes Care. 2018;41:S38-S50. [PMID: 29222375] doi:10.2337/dc18-S004 CrossrefMedlineGoogle Scholar5. Barnett DM. Elliott P. Joslin, MD: A Centennial Portrait. Boston: Joslin Diabetes Center; 1998. Google Scholar6. Willens D, Cripps R, Wilson A, Wolff K, Rothman R. Intradisciplinary team care of diabetic patients by primary care physicians, advanced practice nurses and clinical pharmacists. Clinical Diabetes. 2011;29:60-68. CrossrefGoogle Scholar7. Piette JD, Wagner TH, Potter MB, Schillinger D. Health insurance status, cost-related medication underuse, and outcomes among diabetes patients in three systems of care. Med Care. 2004;42:102-9. [PMID: 14734946] CrossrefMedlineGoogle Scholar8. Kupersmith J, Francis J, Kerr E, Krein S, Pogach L, Kolodner RM, et al. Advancing evidence-based care for diabetes: lessons from the Veterans Health Administration. Health Aff (Millwood). 2007;26:w156-68. [PMID: 17259199] CrossrefMedlineGoogle Scholar9. Stone RA, Rao RH, Sevick MA, Cheng C, Hough LJ, Macpherson DS, et al. Active care management supported by home telemonitoring in veterans with type 2 diabetes: the DiaTel randomized controlled trial. Diabetes Care. 2010;33:478-84. [PMID: 20009091] doi:10.2337/dc09-1012 CrossrefMedlineGoogle Scholar10. Draznin B, Nathan DM, Korytkowski MT, McDonnell ME, Golden SH, Schutta MH, et al. Guidelines versus guidelines: what's best for the patient? Ann Intern Med. 2018;169:186-7. [PMID: 29800101]. doi:10.7326/M18-0939 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Keck School of Medicine of the University of Southern California, Los Angeles, California (A.L.P.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2941.Corresponding Author: Anne L. Peters, MD, Division of Endocrinology, Keck School of Medicine of the University of Southern California, 9033 Wilshire Boulevard, Suite 406, Los Angeles, CA 90211; e-mail, [email protected]usc.edu.This article was published at Annals.org on 20 November 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIntermediate Diabetes Outcomes in Patients Managed by Physicians, Nurse Practitioners, or Physician Assistants George L. Jackson , Valerie A. Smith , David Edelman , Sandra L. Woolson , Cristina C. Hendrix , Christine M. Everett , Theodore S. Berkowitz , Brandolyn S. White , and Perri A. Morgan Metrics Cited byIntermediate Diabetes Outcomes in Patients Managed by Physicians, Nurse Practitioners, or Physician AssistantsJames Grote, MDIntermediate Diabetes Outcomes in Patients Managed by Physicians, Nurse Practitioners, or Physician AssistantsP. Dileep Kumar, MD 18 December 2018Volume 169, Issue 12Page: 875-876KeywordsDisclosureElectronic medical recordsEndocrinologyExercise therapyHbA1cInsulinNursesPrimary care physiciansTelemedicineVeteran care ePublished: 20 November 2018 Issue Published: 18 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...