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June 27, 1980

Rx for nurse-practitioner—physician teams

JAMA. 1980;243(24):2474-2479. doi:10.1001/jama.1980.03300500006003

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A 24-year-old man comes to a clinic staffed by a nurse-practitioner. His history is that of abdominal pain, but numerous upper gastrointestinal and barium enema examinations all have yielded negative results. He smokes heavily and probably does not take the antacids that have been prescribed for him. Should the nurse-practitioner treat this patient, or should he be referred to the physician with whom the nurse-practitioner works?

More important, would the two health care practitioners agree on which one could more effectively treat this patient?

As thousands of newly trained nurse-practitioners enter the health care system in the next few years, nurse-practitioner-physician teams will not be uncommon. Such teams may offer improved patient care by combining what should be complementary attitudes and skills. "Research has shown," says Robert Fletcher, MD, "that physicians are more disease-oriented, while nurses concentrate more on psychological and social components of disease."

Do these traditionally perceived roles