Since that time it has changed from an assistant role to one of meeting peoples healthcare needs when a primary care physician is not available the roles of nurse practitioner and physician assistant are evolving alongside that of physicians with expanding opportunities in specialty medicine being a dominant trend affecting health . 41 based on these estimates the use of nurse practitioners and physician assistants in the delivery of primary care could result in substantial health care savings if implemented in other states. Twitchell is among a growing number of americans who over the past two decades have been going to either a physician assistant or nurse practitioner for their primary care needs in the early 1990s the public was not as familiar with nurse practitioners which is very different from today says ruth palma a nurse practitioner at the . In the current era of primary care physician shortages a frequently discussed approach to the pcmh involves increasing the presence of physician assistants and nurse practitioners pa nps on the primary care team 14 17 effective incorporation of pa nps into primary care teams requires implementation of well defined roles 1318 21. The number of nurse practitioners and physician assistants practicing primary care in the united states primary care workforce facts and stats no 2 summary in 2010 approximately 56000 nurse practitioners and 30000 physician assistants were practicing primary care in the united states according to research commissioned by the agency for
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