title: Nurse practitioners and physician assistants employed by general and subspecialty pediatricians.
abstract: OBJECTIVE
  There is little nationally representative information describing the current manner in which nurse practitioners (NPs) and physician assistants (PAs) work in pediatric practices and their professional activities. To understand better the current NP and PA workforce in pediatric primary and subspecialty care, we conducted a national survey of pediatricians.
  
  
  METHODS
  A survey study of a random national sample of 498 pediatric generalists and 1696 subspecialists in the United States was performed by using a structured questionnaire administered by mail. The survey focused on practice settings, employment, and scope of work of NPs and PAs.
  
  
  RESULTS
  Response rates were 72% for generalists and 77% for subspecialists. More than one-half (55%) of generalists reported that they do not currently work with NPs or PAs, compared with only one-third of subspecialists who do not. Many generalists and subspecialists intend to increase the number of NPs and PAs in their practices in the next 5 years. More generalist and subspecialty practices work with NPs than with PAs. There was great variability between generalists and subspecialists and among different subspecialties in the proportions that worked with NPs and PAs. The scope of work of NPs and PAs also varied between generalists and subspecialists.
  
  
  CONCLUSIONS
  Planned increases in the number of NPs hired and expansion of their scope of work might put subspecialists and general pediatricians in competition with regard to recruitment and hiring of a limited pool of new pediatric NPs. Similar issues might arise with PAs.
authors: Child Health Evaluation and Research Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109-0456, USA. gfreed@med.umich.edu
authors: Gary L
authors: GL
authors: Freed
authors: Kelly M
authors: KM
authors: Dunham
authors: Carol
authors: C
authors: Loveland-Cherry
authors: Kristy K
authors: KK
authors: Martyn
authors: Marc J
authors: MJ
authors: Moote
mesh_terms: D000328:Adult; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000706:statistics & numerical data* / Q000639:trends; D010370:Pediatric Assistants / Q000706:statistics & numerical data* / Q000639:trends; D010372:Pediatrics / Q000191:economics / Q000706:statistics & numerical data; D010560:Personnel Selection; D024382:Professional Role; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce