Summary
Midlevel providers as part of the US Emergency health care teams: roles, responsibilities and future directions
Stahmer SA, Harrison D, Rosado S
Affiliation of the authors
University of North Carolina/Chapel Hill, Department of Emergency Medicine, Chapel Hill, Carolina del Norte, USA Clinical Associate Faculty, Duke University School of Medicine, Clinical Observation Unit, Division of Emergency Medicine, Duke University Hospital, Durham, Carolina del Norte, USA.
DOI
Quote
Stahmer SA, Harrison D, Rosado S. Midlevel providers as part of the US Emergency health care teams: roles, responsibilities and future directions. Emergencias. 2014;26:61-8
Summary
The concept of training nonphysician health care providers originated in the mid-1960s,
when a shortage of primary care physicians was projected. The original intent was to
compensate for shortages of primary care physicians. Since then the roles, responsibilities,
and autonomy of practice of midlevel providers (MLPs) have evolved in a number of
directions. The goal was initially to have the MLP provide care in less acute medical events
and work under the supervision of a physician, but many have begun to work with
relative autonomy in recent years, caring for increasing numbers of acutely ill patients and
taking on responsibilities outside of direct patient care. The literature shows that MLPs
offer quality of the care that is comparable to physicians care. They have the potential to
fill important roles in areas such as patient communication, monitoring of compliance
with care guidelines and transitions in care, and in education and research. Current issues
are the need to ensure standardization of training, define the scope of MLP care and
practice, and address concerns about professional threat to specialist in emergency
medicine.