Substitution of Doctors by Nurses in Primary Care

A Cochrane Review was recently published that states "appropriately trained nurses can produce as high quality care as primary care doctors and acheived as good health outcomes for patients."

Nurse-doctor substitution in primary care is intended to reduce costs, increase service capacity and reduce doctors’ workload, while maintaining quality of care. It could also help to meet the increasing demand due to ageing populations and support the shift in care from hospitals to primary care.

The researchers analysed 16 studies from around the world that looked at the effects of substituting nurses for doctors in primary care to see the impact on health outcomes (e.g. morbidity, mortality, patient satisfaction, and quality of life), standards of care, and use of healthcare resources.

The authors found that health outcomes were similar for nurses and doctors, but patient satisfaction was higher with nurse-led care. Nurses spent longer over consultations and higher rates of patient recall than doctors.

Read the full report by clicking the Cochrane Library link on the Medical Library Website, and searching for the following title.

Laurant, M. Sergison, M. Sibbald, B. Substitution of doctors by nurses in Primary Care. [Protocol] Cochrane Effective Practice and Organisation of Care Group Cochrane Database of Systematic Reviews. 1, 2005.