Morgan W A
West J Med. 1980 Mar;132(3):259-64.
Twenty-six rural California clinics have employed nurse practitioners (NP's) or physician's assistants (PA's) to meet the primary health care needs of local communities. Of the 24 NP's and 5 PA's involved, 11 were men and 18 were women. Their average age was 37, and all but five were trained in California. The clinics, with less than 50 percent on-site physician supervision, averaged 19 miles in distance from the nearest physician (ranging up to 63 miles). More than half the clinics were satellites of central, physician-staffed, nonprofit clinics, a third were community-administered and two were private. Half served a whole community, a quarter were established to serve Indians and a quarter to serve Chicanos. Each NP or PA saw an average of 13 patients a day. All nonprivate clinics received subsidies from a variety of local, state and federal funds. Four of the clinics had closed or had no medical staff at the time of our survey.NP/PA clinics are proving to be a feasible and valuable means of offering essential health care needs to remote communities.
加利福尼亚州的26家乡村诊所雇佣了执业护士（NP）或医师助理（PA），以满足当地社区的基本医疗需求。在参与其中的24名执业护士和5名医师助理中，11人为男性，18人为女性。他们的平均年龄为37岁，除了5人之外，其他人都是在加利福尼亚州接受的培训。这些诊所现场医师监督比例不到50%，距离最近的医师平均有19英里（最远达63英里）。超过半数的诊所是由配备医师的中央非营利诊所设立的卫星诊所，三分之一由社区管理，两家为私立诊所。一半诊所服务整个社区，四分之一是为印第安人设立的，四分之一是为墨西哥裔美国人设立的。每位执业护士或医师助理平均每天看诊13名患者。所有非私立诊所都获得了来自各种地方、州和联邦基金的补贴。在我们进行调查时，有4家诊所已经关闭或没有医疗人员。事实证明，执业护士/医师助理诊所是为偏远社区提供基本医疗需求的一种可行且有价值的方式。
