The National Ambulatory Medical Care Survey: PAs and NPs in outpatient surgery

Background: This study aimed to determine the prevalence and occupational characteristics of physician assistants (PAs) and nurse practitioners (NPs) in outpatient surgical subspecialty clinics. Methods: The 2007 and 2008 National Ambulatory Medical Care Survey (NAMCS) databases were queried for the number and characteristics of office visits seen by different provider types (PAs or NPs, physicians, or both) in various surgical subspecialties. Results: More than 250 million weighted sample visits were analyzed. PAs or NPs were involved in 5.9% of visits, though the percentage of patients seen by them alone (1.1%) was significantly lower (P<0.0001). PAs and NPs were more likely to be involved in pre-or postoperative visits, and often saw the same diagnoses alone as physicians only. The most common procedures performed by PAs and NPs varied according to subspecialty. Conclusions: PAs and NPs have a minor prevalence in the ambulatory surgical workforce during the time period studied. Further integration of these providers into the outpatient setting may help optimize efficiency in ambulatory surgical care.