Child Health Evaluation and Research Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109-0456, USA.
Pediatrics. 2011 Oct;128(4):665-72. doi: 10.1542/peds.2011-0329. Epub 2011 Sep 2.
There is little nationally representative information describing the current manner in which nurse practitioners (NPs) and physician assistants (PAs) work in pediatric practices and their professional activities. To understand better the current NP and PA workforce in pediatric primary and subspecialty care, we conducted a national survey of pediatricians.
A survey study of a random national sample of 498 pediatric generalists and 1696 subspecialists in the United States was performed by using a structured questionnaire administered by mail. The survey focused on practice settings, employment, and scope of work of NPs and PAs.
Response rates were 72% for generalists and 77% for subspecialists. More than one-half (55%) of generalists reported that they do not currently work with NPs or PAs, compared with only one-third of subspecialists who do not. Many generalists and subspecialists intend to increase the number of NPs and PAs in their practices in the next 5 years. More generalist and subspecialty practices work with NPs than with PAs. There was great variability between generalists and subspecialists and among different subspecialties in the proportions that worked with NPs and PAs. The scope of work of NPs and PAs also varied between generalists and subspecialists.
Planned increases in the number of NPs hired and expansion of their scope of work might put subspecialists and general pediatricians in competition with regard to recruitment and hiring of a limited pool of new pediatric NPs. Similar issues might arise with PAs.
目前有关执业护士（NPs）和医师助理（PAs）在儿科实践中的工作方式及其专业活动的全国代表性信息较少。为了更好地了解儿科初级保健和亚专科护理中当前的 NP 和 PA 劳动力，我们对儿科医生进行了一项全国性调查。
采用邮寄方式，对美国的 498 名儿科普通科医生和 1696 名亚专科医生进行了一项随机全国性样本的调查研究。该调查侧重于 NP 和 PA 的实践环境、就业和工作范围。
普通科医生的回复率为 72%，亚专科医生的回复率为 77%。超过一半（55%）的普通科医生表示他们目前没有与 NPs 或 PAs 一起工作，而只有三分之一的亚专科医生没有。许多普通科医生和亚专科医生计划在未来 5 年内增加其实践中的 NP 和 PA 人数。与 PAs 相比，更多的普通科和亚专科实践与 NPs 合作。普通科医生和亚专科医生之间以及不同亚专科之间，与 NPs 合作的比例存在很大差异。NP 和 PA 的工作范围也在普通科医生和亚专科医生之间存在差异。
计划增加聘用的 NPs 人数并扩大其工作范围，可能会使亚专科医生和普通儿科医生在招聘和聘用有限数量的新儿科 NPs 方面产生竞争。PA 可能也会出现类似的问题。
