Reprinted from the Health District's quarterly publication mailed to district residents (Winter 2005)

Forty years ago, a national shortage of physicians prompted the nation’s first physician assistant and nurse practitioner programs.

Today, these types of healthcare providers are improving access to high-quality, cost-effective health care.

Physician assistants (PAs) and nurse practitioners (NPs), sometimes called midlevel providers, treat patients’ medical concerns and educate and empower people of all ages to take better care of themselves.

“Midlevels expand availability to a clinic and patients,” says Dr. Jacqueline Fields, a medical doctor who practices with a physician assistant at Healing Gardens Health Center in Fort Collins. “My midlevel has 15 years’ experience taking care of the full scope of family practice cases.”

A physician assistant is a healthcare professional who practices medicine with physician supervision. The American Academy of Physician Assistants says: “PAs, working with the supervision of physicians, provide care that is comparable to physician care.”

“We’re qualified to do about 85 percent of what physicians do,” says Della McGuire, a PA at Healing Gardens. Among other services, McGuire conducts physical exams; diagnoses and treats illnesses; helps patients get to the root of specific medical problems, such as hypertension and hormonal imbalances; orders and interprets tests, and prescribes medications.

“PAs give more time to patients and provide more education,” McGuire says. Her patients benefit from the expertise of two medical professionals: Hers and that of Dr. Fields, who as supervising physician reads all patient charts and provides insight and guidance on McGuire’s cases.

Nurse practitioners are licensed registered nurses prepared at the graduate level to provide preventive and acute healthcare services. NPs provide the same functions as PAs but may work either independently or in collaboration with other healthcare providers.

“NPs can serve in the areas of family care, pediatrics, obstetrics, general women’s health, mental health, acute care, urgent care, and occupational health,” says Kathy Kruse, an independent nurse practitioner who provides counseling on emotional and spiritual aspects of disease, illness and life transitions.

NPs use a holistic approach that looks at how a person’s body, mind and spirit impact wellness and illness, Kruse says. A nurse practitioner emphasizes care as well as cure, with teaching being a main focus, she says. “The more a person can learn about her unique self, the greater the chances for her health and wellness.”

Kruse points out that PAs and NPs should take the initiative to consult with or recommend a physician when a medical problem is very complicated or beyond their level of expertise.

Physicians should handle “very complicated cases,” advises Dr. Fields. “NPs and PAs may have not have the background required to manage all aspects of a difficult case.

As healthcare moves to a more team-based approach, providers like PAs and NPs will play an increasingly important role in helping people of all ages prevent and combat illnesses, manage chronic conditions, and achieve optimal health.