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Harold C. Sox, MD

JAMA. 2000;283:106-108.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

An important article about primary health care appears in this issue of THE JOURNAL. This study by Mundinger et al¹ reports an attempt to settle definitively a long-standing policy question: can nurse practitioners in independent practice provide primary health care of the same caliber as can physicians? In previous studies, nurse practitioners and physicians worked in the same practice and had an understanding that the nurse practitioner would consult the physician about patients with difficult problems.^2-3 Twenty years later, nurse practitioners have gained the right to practice independently in 22 states.⁴ In all but 1 of the states that require physician supervision, the supervising physician need not be present during the provision of care. The Balanced Budget Act of 1997 expanded direct Medicare reimbursement to nurse practitioners in all nonhospital sites and removed any requirement for physician supervision.⁵

Now, the study by Mundinger et al provides . . . [Full Text of this Article]

Author Affiliation: Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

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