Published on
A recent Cochrane review and meta-analysis evaluated the impact of “substituting nurses for physicians” in the hospital setting, based on the rationale that demand for health services is increasing worldwide at a time when there is also a shortage of physicians. Leveraging nurses more could be a way to improve access for many provider organizations. Across 80 randomized studies involving about 28,000 patients in 20 countries, researchers from Ireland, United Kingdom, and Australia found advanced nurse practitioners, clinical nurse specialists, and registered nurses provide care across multiple specialties. Pooled analyses showed little to no difference between nurse-led and physician-led care in key measures, including: mortality (risk ratio [RR] 1.03, 95% confidence interval [CI] 0.87–1.21; 19 studies, 8,239 participants); quality of life (standardized mean differences [SMD] 0.10, 95% CI −0.04 to 0.23; 22 studies, 5,246 participants); self-efficacy (SMD 0.01, 95% CI −0.06 to 0.09); and patient safety events (RR 0.92, 95% CI 0.84–1.01). While most clinical outcomes were comparable, nurse-led care demonstrated advantages in selected areas such as diabetes management and cancer follow-up, while physicians performed better in certain sexual health services. Overall, the evidence suggests nurse substitution can maintain safety and effectiveness, though implementation depends on training, supervision, and workforce considerations.
Urgent care does that: Of note, the substitution models varied widely, according to a relatedpress release, with nurses operating autonomously, under supervision, or following other specialized protocols. In some cases, patients had earlier, more frequent, or on-demand appointments with nurses, or experienced added educational components, which may have influenced outcomes. With its impressive market growth and its model of reliance on nurse practitioners and physician assistants, urgent care could likely provide evidence of optimal models for expanding clinical roles across the broader healthcare ecosystem.