A clinical care extender is someone working in a capacity that helps to broaden access to medical care. These positions typically include the physician's assistant (PA) and nurse practitioner (NP), both of which can cover certain duties that doctors traditionally provide. Some clinical care extenders have prescriptive authority and are permitted to practice independently of doctors. Those occupying such positions are also commonly called "physician extenders." Others practice in specialty areas, such as in anesthesia or midwifery.
Started out of a need for more physicians in the 1960s, the PA role was created. Training is designed to be a quick version of medical school, during which students are expected to complete two years of the curriculum. Under the supervision of a medical doctor, this clinical care extender provides the same care as physicians, such as writing prescriptions, ordering tests, and performing physical exams.
Duties performed by the PA overlap with NP practice. Nurse practitioners diagnose illness, write prescriptions in some states in the United States, as well as order and interpret diagnostic test results. Practice settings are varied, though most are employed by physicians, clinics, and hospitals. NPs generally provide care to designated populations, such as pediatrics, or are experts in dealing with a particular health issue. Some specialize in primary care.
Access to specific quality medical care is limited for those living in rural communities or belonging to low socioeconomic groups and such areas of medicine tend not to attract doctors or new medical school graduates, leaving lots of people without primary care providers. Sectors falling into these categories are often able to obtain medical services by a clinical care extender. Certified registered nurse anesthetists (CRNAs) are registered nurses who actually do the job of an anesthesiologist, administering anesthesia to patients undergoing surgical procedures. Certified nurse midwives (CNMs) are another type of clinical care extender trained to provide health services to expectant mothers, but also able to do Pap smears, prenatal exams, and prescribe birth control methods, as well as deliver babies, diagnose and treat sexually-transmitted diseases, and deal with other gynecological conditions. Most CNMs work with or under the supervision of a doctor.
Clinical care extender jobs are considered to be a more cost-effective way to deliver primary care when compared to allopathic doctors and specialists. Health maintenance organizations, hospitals, and clinics look to physician extenders to help to reduce the costs. All are able to provide the same care to more patients. Complex health cases are increasingly handled by traditional physicians and those occupying specialty fields.