When presented either with patients who had upper respiratory infections, patients with upper respiratory infections and back pain, patients with upper respiratory infections and headaches, or patients will all three conditions, the researchers found that advanced practice clinicians made the same judgment calls as physicians when ordering antibiotics, CT scans, MRIs, radiography or referrals in both hospitals and offices.
One notable difference between the groups was in hospital-owned general medical clinics, wherein physicians made referrals and wrote antibiotic prescriptions less often than advanced practice clinicians. While the study suggests the divide between advanced practice clinicians and physicians may not be that significant, at least in the limited scenarios that formed the basis of the study, there could be other factors at play.
“Perhaps URIs, headache, and low back pain represent additional examples in which the more extensive training of primary care physicians does not contribute to higher-value care,” Eugene Rich, MD, wrote in a commentary published along with the paper.
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