As covered by Medscape:
“Nurse practitioners’ diagnostic reasoning abilities compared favourably to those of doctors in terms of diagnoses made, problems identified and action plans proposed from a complex case scenario.”
Certainly not delving into the myriad of issues associated with healthcare roles and training, but, from a critical appraisal standpoint:
- A gold standard for acute clinical evaluation determined by a general practioner, a rheumatologist, and a diabetes nurse practitioner.
- An inability to recruit 30 physicians to match the 30 NPs for the study, and thus it proceeded with only 16.
- Many of the “correct diagnoses” involved in their test of equivalency were related to chronic health maintenance, and not the acute illness of presentation.
- The NPs recruited having had almost 30 years of clinical experience, compared with the physicians all still in training, with an average 6 years of experience, several of whom were engaged non-primary care (e.g., cardiology) specialties.
The commentary on Medscape waxes poetic regarding reconciliation of independence and oversight issues based on this “evidence”. The limitations in these data are so profound that this study is virtually meaningless – and serves no function in further illuminating the safety or effectiveness of scope of practice, as these authors unfortunately attempt.
“Nurse practitioners versus doctors diagnostic reasoning in a complex case presentation to an acute tertiary hospital: A comparative study”
http://www.ncbi.nlm.nih.gov/pubmed/25234268