Nurse practitioners' and physicians' views of NPs as providers of primary care to veterans.
OBJECTIVE
To describe NPs' and MDs' perceptions of the role of NPs, the degree of collegiality between professions, and NPs' feeling of acceptance, three relationship components that may affect the acceptance of NPs as providers of primary care.


METHODS
A descriptive study including both closed- and open-ended questions plus several Likert-type questions conducted June-August 2004. Our sample included all primary care NPs (87) and MDs (162) within a Midwestern Veterans Health Administration (VHA) region. Data were collected from 153 providers.


RESULTS
NPs saw their role as one of autonomous practice with physician back-up as needed, while MD respondents envisioned a role akin to a physician extender. Most of the physician respondents did not think NPs could provide adequate primary care to veterans who tend to have many comorbid conditions. Yet both groups considered their relationships to be collegial and most NPs felt accepted by physicians. MDs particularly valued NPs' teaching and interpersonal skills leading to greater patient satisfaction.


CONCLUSIONS
To facilitate the teamwork of NPs and MDs while improving utilization of NPs as primary care providers, VHA officials should routinely clarify roles, monitor quality of care of both MDs and NPs, and provide feedback to all concerned.
Fletcher
Carol E
CE
VA Ann Arbor Healthcare System, Ann Arbor, MI 48113-0170, USA. cefletch@umich.edu
Baker
S Jill
SJ
Copeland
Laurel A
LA
Reeves
Pamela J
PJ
Lowery
Julie C
JC
D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003299:Cooperative Behavior; D032022:Delegation, Professional / Q000458:organization & administration; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology*; D015146:Midwestern United States; D009722:Nurse Practitioners / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D017060:Patient Satisfaction; D019555:Physician-Nurse Relations; D011320:Primary Health Care / Q000458:organization & administration*; D017009:Professional Autonomy; D036301:Qualitative Research; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans; D016526:Workload