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In Reply Mr McGinnity takes issue with our statement regarding PAs and NPs in the VA health care system. To be clear, we did not impugn PAs or NPs. The exact language we used was: “Although advocated by some, hiring nurse practitioners and physician assistants to replace primary care physicians may be an unwise strategy. This is not the time to test unproven and controversial solutions.”
Our opinion is that PAs and NPs should not replace physicians. We strongly believe that PAs and NPs are valuable members of the care team and we did not intend to trivialize or diminish their important role. All 3 authors work closely with PAs, NPs, or both who are integrated into care teams and perform at high levels. However, adding PAs and NPs outside of this model, as some have proposed, risks leaving them exposed, undersupervised, and underrewarded.
Bakaeen FG, Blaustein A, Kibbe MR. Physicians Assistants in VA Medical Centers—Reply. JAMA. 2014;312(21):2289-2290. doi:10.1001/jama.2014.14502