Although most doctors and nurses can work together to help the sick, a new study finds that doctors don't believe nurse practitioners should expand their authority and scope of practice, a study released yesterday in the New England Journal of Medicine.

The study surveyed 505 primary care physicians and 467 nurse practitioners. On the subject of whether advanced practice nurses should lead medical homes, delivering team-based, coordinated care to patients, 17 percent of the primary care physicians agreed whereas 82 percent of nurse practitioners felt it was a good idea. The idea of nurse practitioners having a larger role has arisen due to concerns about a shortage in doctors since an estimated 25 million people will gain insurance under the Affordable Care Act. Nurse practitioners want to help where doctors might not be able to, Kaiser Health News reported.

The differences in these health care providers' viewpoints doesn't stop there either. The two groups also disagree on the idea of equal pay for nurse practitioners providing the same services as the doctors. More than 64 percent agreed with it while less than four percent of doctors felt it was a good idea. When researchers asked if they felt the quality of care given by physicians in exams and consultations was better than what the nurse practitioners were providing, 66 percent of doctors agreed, while 75 percent of nurses disagreed.

According to Glassdoor, a job and career information website, the average salary of a nurse practitioner is $87,000, compared to a primary care physician's $137,774.

"We've done a lot of comparative surveys with health professionals but we've never just found gaps this big," Dr. Karen Donelan, an assistant professor of medicine at the Harvard School of Medicine and the study's lead author, told KHN. "When we get on the ground and we survey the people actually doing the work and working together, we see some of those professionals come close together. We didn't observe that here."

The only thing both groups were able to come to an agreement on was that increasing the number of nurse practitioners would be better for treating patients as fast as possible. Still, less than a third of doctors felt this increase would improve safety or effectiveness of care.

In a February 2013 KHN interview with David Herbert, the CEO of the American Association of Nurse Practitioners, he said that "nurse practitioners have been practicing safely and providing great outcomes for decades."

"As a team, this kind of inter-professional disagreement is not a good thing when we're trying to achieve better teamwork." Donelan said. "The conflict over roles has got to be worked out so that it's clear for patients when they get their care."


K Donelan, C DesRoches, R Dittus, et al. Perspectives of Physicians and Nurse Practitioners on Primary Care Practice. New England Journal of Medicine. May 2013. Accessed May 16, 2013.