Midlevel Providers: The Future of Hospital Medicine, or “Here Today, Gone Tomorrow”?

In the February 2010 issue of the Journal of Hospital Medicine, four physicians discuss using midlevel providers (MLPs), namely physician assistants and nurse practitioners, as a solution to current and future physician shortages. One pair maintains that MLPs can provide improvement in hospital continuity and can offer a multidisciplinary approach. The other two physicians agree that MLPs have a well-established role on protocol-driven inpatient services, but they believe that the diagnostic and therapeutic complexity of a general medicine service requires additional training.

Two physicians from Pennsylvania cite studies showing that integrated MLPs improve quality of care and lower costs. They discuss models of care in which MLPs can serve…