amednews: Most ED patients willing to wait longer to avoid nondoctor care :: Aug. 30, 2010 … American Medical News

Nurse practitioners and physician assistants account for at least 10% of outpatient visits and increasingly are being used to handle patient care in emergency departments, according to previous research. 

But a new survey said 80% of patients expect to see a physician when they come to the ED. Fewer than half would be willing to see an NP or PA for an ankle injury — they would rather wait two more hours to be cared for by a physician.

via amednews: Most ED patients willing to wait longer to avoid nondoctor care :: Aug. 30, 2010 … American Medical News.

For the record, if I went to the ED with a straightforward, well defined problem I’d just as soon see a PA/NP if it’s quicker.  (And, per the article, I’d like to know who’s seeing me and my problem).

Also for the record, my ED doesn’t utilize midlevels at all, so my knowledge of working with them is from my residency and my prior job, over 8 years ago.

Nearly every discussion I have with colleagues from other departments has a time when they are surprised we don’t have midlevels, and tell me the benefits, which boils down to either a) ‘they make us money’ or b) they do all our procedures, so they’re better at them than we are.

I find ‘a’ objectionable, but that’s just me.  ‘B’ is somewhat more defensible as it at least implies an increased level of patient care, but at the cost of a physician voluntarily relinquishing skills, then using that lack of practice as evidence of the superiority of others.  This has a rather obvious answer, which I’m too polite to point out to them.

I’m not saying there are no roles for midlevels in some ED’s, but I have yet to hear a compelling argument for them from a patient care aspect.

So, school me BUT do it without denigrating anyone else.