A substantial majority of nurse practitioners and physician assistants are satisfied with the physician-led health care model, according to an American Medical Association survey, even as the national organization has identified scope as the primary ongoing legislative concern for the Texas Medical Association and other state medical societies.
The study, debuted at the AMA’s annual State Advocacy Conference in Rancho Palos Verdes, Calif., on Jan. 6-8, reinforces medicine’s advocacy about the vital role physician leadership has in providing quality care emphasizing patient safety.
“The AMA has long supported physician-led care, as research consistently demonstrates that physician involvement leads to better patient outcomes and ensures the highest standards of safety,” AMA said in a statement accompanying its nurse practitioner survey insights one-pager.
Despite pushes at the state and federal level for scope expansion for nurse practitioners, those efforts are “not agreeing with what most nurse practitioners want. Most nurse practitioners are happy with physician-led health care, and that’s what our patients want, too,” said TMA President Jayesh “Jay” Shah, MD.
The AMA survey of 502 nurse practitioners found that 95% practice on a physician-led team, including those who “work with a collaborating or supervising physician (78%), work as part of a physician-led team (75%), and/or have a written practice agreement with a physician (72%).” Of those nurse practitioners on physician-led teams, 88% reported being satisfied; more than half reported they were very satisfied.
The survey also revealed:
- 98% said collaborating and discussing complex patient cases with physicians is a benefit, with 88% citing it as a major benefit;
- 94% valued physician mentorship;
- 89% cited patient safety as a key benefit to physician-led care; and
- 88% listed liability protection as a key benefit.
AMA also surveyed 500 physician assistants, with 100% saying they work on physician-led teams. A full 94% of respondents expressed satisfaction, with 60% saying they were very satisfied.
Patients also value physician-led care per AMA’s State Advocacy Impact Report, which states 91% of patients “say a physician’s years of education and training are vital to optimal patient care,” while 95% “say it’s important for a physician to be involved in their diagnosis and treatment decisions.”
Dr. Shah points out that physicians’ extensive training allows them to develop a “clinical eye” that sets them apart from nurse practitioners and physician assistants.
“That doesn’t happen online. That doesn’t happen just by a limited 500 hours,” he said, referring to virtual modes of teaching and clinical training hour requirements for an advanced practice registered nurse. “That’s why we have medical students going through 15,000 hours of clinical training, because that’s what it takes to develop that clinical eye.”
Read more about TMA’s wins fighting scope creep in the 2025 Texas Legislature.
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.