1974

Burlington randomized trial on health outcomes (with 1598 families randomly assigned to FP [family practice physician] or NP [nurse practitioner] groups working in consultation with physicians: NPs able to safely and effectively manage 67% of their patient visits without physician consultation (DeAngelis, 1994, citing Spitzer, et al., NEJM, 290:251-56, 1974). BUT: “. . . although NPs may be able to manage two thirds of single patient encounters without physician consultation, that is not the same as managing two thirds of the patients over time. Any single patient would probably need the expertise of a physician at some point in time (DeAngelis, 870).