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Editor's Note
January 2015

The Right Care by the Right Clinician

JAMA Intern Med. 2015;175(1):108. doi:10.1001/jamainternmed.2014.6441

Increased demand for primary care has resulted in the increased use of advanced practice clinicians (nurse practitioners and physician assistants) to supplement the physician workforce. It is natural to ask how the care delivered by these advanced practice clinicians differs from the care provided by physicians.

In this article, Hughes et al1 find that advanced practice clinicians order modestly more radiologic tests (0.3%) than primary care physicians among Medicare patients. However, this overall percentage difference obscures a more important finding. When the investigators focused on a common problem in primary care, lower back pain, they found that advanced practice clinicians ordered no more imaging tests than physicians, and when the investigators limited the sample to patients with acute respiratory illness, advance practice clinicians actually ordered fewer imaging tests.

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