Midlevel Providers:

Midlevel Providers is a term used to designate providers that are not physicians, but are licensed to diagnose and treat patients under the supervision of a physician.  Nurse practitioners and Physician Assistants both fall into this category of providers.

Nurse Practitioner:

A nurse practitioner (NP) is a registered nurse (RN) who has completed advanced education and training in the diagnosis and management of common medical conditions, including chronic illnesses.  Nurse practitioners provide a broad range of health care services in all fifty states.  They provide some of the same care provided by physicians and maintain close working relationships with physicians.  They train in a specialized area, such as pediatrics or family practice. A nurse practitioner can serve as a patient's regular health care provider, though in our office they work in conjunction with the family's regular pediatrician.  Their specialty began in the late 1960’s when there were predictions of physician shortages and nurses with higher level training were afforded the ability to evaluate and treat patients with varying degrees of supervision by physicians.

The core philosophy of the field is individualized care with priorities in prevention, wellness and patient education.  This can mean fewer prescriptions and less expensive treatments. Informing patients about their health care and encouraging them to participate in decisions are central to the care provided by NPs.

Physician Assistants

Physician Assistants are health care professionals licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and write prescriptions. Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA's practice may also include education, research, and administrative services.

Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. Upon graduation, physician assistants take a national certification examination developed by the National Commission on Certification of PAs in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a recertification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.

At Pediatric Partner’s we use Midlevel Providers for the following:

• Providing well-child care, including screening and immunizations
• Diagnosing and treating acute illnesses, infections and injuries
• Diagnosing, treating and monitoring chronic diseases (e.g., asthma)
• Obtaining medical histories and conducting physical examinations
• Collaborating with physicians and other health professionals as needed, including providing referrals
• Ordering, performing and interpreting diagnostic studies (e.g., lab tests, x-rays, EKGs)
• Prescribing most medications (our Midlevels do not prescribe controlled substances, such as those used to treat ADHD... please see your physician for those visits)
• Prescribing physical therapy and other rehabilitation treatments
• Counseling and educating patients on health behaviors

In summary, midlevel providers provide high-quality, cost-effective individualized care that is comparable to the health care provided by physicians.  Their services are usually covered by insurance providers.  At Pediatric Partners, we use them as an extension of medical services provided by our physicians.  They staff our walk-in clinics.  You may schedule appointments as always with your usual pediatrician, but you are also able to schedule appointments with a nurse practitioner or physician assistant.  This increases flexibility in scheduling for our patients.  We hope that patients and their families agree that the midlevel providers add another valuable aspect to Pediatric Partners!