Team-based care that included nurse practitioners (NPs) and physician assistants (PAs) increased the practice capacity for primary care physicians, according to a study published in Family Medicine.

A team of researchers used data from American Board of Family Medicine practice demographic questionnaires completed by family physicians to understand how NPs and PAs have an impact in family physician practices.

Family physicians self-reported patient panel sizes with primary care teams categorized as NP only, PA only, both, or neither.

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A total of 27,836 family physicians (61.1% men; mean age, 51.6 years) were included in the study. The average reported panel size was 2263; however, nearly 43% of physicians did not estimate a panel size.

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PAs and NPs were not employed in 30.3% of practices. Of the remaining practices, 25.7% included only NPs, 12.9% included only PAs, and 31.1% included both.

PAs and/or NPs included in family practices significantly increased panel size and scope of practice. Compared with practices that employed neither NPs nor PAs, the most significant increase in scope of practice was observed in practices that employed PAs only; employing only NPs or both was also associated with a significant, but smaller, increase in panel size and scope of practice score.

“This study offered confirmative evidence that variations in practice team configuration were associated with [family physicians’] patient panel size and scope of practice, suggesting that optimized teams may enable primary care physicians to practice at higher capacity than poorly configured ones,” the authors noted.


Dai M, Ingram RC, Peterson LE. Scope of practice and patient panel size of family physicians who work with nurse practitioners or physician assistants. Fam Med. 2019;51(4):311-318.