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Comment & Response
December 3, 2014

Physicians Assistants in VA Medical Centers—Reply

Author Affiliations
  • 1Division of Cardiovascular Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
  • 2Division of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
  • 3Surgical Service, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2014;312(21):2289-2290. doi:10.1001/jama.2014.14502

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.