From the Guidelines
Advanced practice providers (APPs) and physicians (MDs) generally achieve similar clinical outcomes in many healthcare settings, though some differences exist, with APPs demonstrating superiority in certain aspects of care such as glycemic control and blood pressure management 1. When comparing the outcomes of APP versus MD care, several factors come into play, including the specific healthcare setting, the complexity of the cases, and the level of collaboration between the two provider types.
- In primary care settings, APPs have been shown to achieve similar or even better outcomes than MDs in managing chronic diseases such as diabetes and hypertension, with studies demonstrating that APPs are more likely to achieve glycemic control and adequate blood pressure control 1.
- In contrast, MDs may have an advantage in complex cases that require specialized knowledge or the management of multiple comorbidities.
- The effectiveness of both APPs and MDs depends significantly on their experience level, specialty training, and the practice environment, with collaborative models that leverage the strengths of each provider type often achieving the best outcomes 1.
- Factors such as scope of practice regulations, supervision requirements, and institutional support systems can also impact outcomes, highlighting the need for flexible and adaptive healthcare systems that prioritize patient-centered care.
- Ultimately, the most successful healthcare delivery models focus on appropriate task distribution based on training and expertise rather than provider type alone, ensuring that patients receive high-quality care from qualified professionals regardless of their credential 1.
From the Research
Outcomes of Advanced Practice Provider (APP) versus Medical Doctor (MD) Care
There are no direct research papers provided to compare the outcomes of Advanced Practice Provider (APP) versus Medical Doctor (MD) care. However, the studies provided offer some insights into the management of patients with complex conditions and the factors that affect physician decision-making.
Factors Affecting Physician Decision-Making
- Internal factors, such as a physician's underlying style or habit, can affect care planning for complex patients with multimorbidity 2
- External factors, such as patient access and resources, can also impact care plans 2
- Relationship-based factors, including collaboration with other healthcare professionals, can influence decision-making 2, 3
- Patient-centered relationship building can lead to better outcomes and increased patient buy-in to care plans 2
Management of Mental Disorders
- General practitioners (GPs) are often comfortable managing common mental disorders, but may struggle with more serious cases 3
- GPs may use pharmacotherapy, support therapy, and psycho-education to treat mental disorders, and often rely on clinical intuition rather than clinical tools 3
- Collaboration with psychologists and psychiatrists is considered key to good mental disorder management 3
Disclosure of Conventional and Complementary Medicine Use
- Patients with chronic conditions may not always disclose their use of conventional or complementary medicine to their healthcare providers 4
- The most common reason for disclosure is to ensure that healthcare providers have a full understanding of the patient's health status 4
- Patient-provider communication and education can improve disclosure rates and lead to better patient outcomes 4
Outcomes in Hypertensive Patients
- Thiazide-type diuretics may be more effective than angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers (CCBs) in reducing cardiovascular disease incidence in certain patient populations 5
- The choice of antihypertensive medication can depend on various factors, including patient demographics and comorbidities 5