title: Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.
abstract: The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging.
  
  
  METHODS
  Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field.
  
  
  RESULTS
  The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies.
  
  
  CONCLUSIONS
  PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.
authors.affiliation: Department of Radiologic Sciences, Midwestern State University, Bridwell Hall Room 210D, 3410 Taft Boulevard, Wichita Falls, TX 76308, USA. Tel 940-397-4083, fax 940-397-4845. vicki.sanders@mwsu.edu.
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Sanders
authors.forename: Jennifer
authors.initials: J
authors.lastname: Flanagan
mesh_terms: D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D010823:Physician Assistants; D024382:Professional Role; D000072177:Radiologists; D011871:Radiology; D000078329:Workforce