The next time you go to your doctor’s office, you may find yourself seeing someone with “PA” or “NP” instead of “MD” after their name. If this happens, don’t be surprised. Physician’s assistants and nurse practitioners, so-called “mid-level” professionals, are often used in busy medical practices to handle increasing patient demands.

There are an estimated 55,000 physician’s assistants in practice in the United States today, according to projections by the American Academy of Physicians Assistants. The American Academy of Nurse Practitioners estimates that there are more than 100,000 nurse practitioners across the country. Both physician’s assistants and nurse practitioners require rigorous training and certification before being eligible to practice.

“These are highly trained individuals,” said Dr Michael Soman, executive medical director, Puget Sound region, for Group Health Cooperative, which uses mid-level professionals extensively at its clinics.

Mid-level professionals work in close relationship with medical doctors in both primary care and specialty environments, and see patients for a wide range of ailments and routine medical care, from colds to annual exams to follow-ups for surgery and urgent care treatment. Most states, including Washington, also allow physician’s assistants and nurse practitioners to write prescriptions, with some restrictions.

“In a primary care setting a physician’s assistant or nurse practitioner could see around 70 percent of the cases that doctors would,” said Linda Brown, CEO of The Doctors Clinic, which currently has two physician’s assistants working in its orthopedic specialty clinic and one nurse practitioner working in its urgent care center.

Convenience and flexibility are among the top benefits of using mid-level professionals, said Dr Soman. By including mid-level professionals on staff, clinics can better respond to patients’ needs to be seen quickly. Busy practices using physician’s assistants and nurse practitioners can accommodate more patients, since many complaints that bring people to the doctor can be seen by these mid-level professionals, avoiding a long wait for a doctor’s appointment.

“They help patients have a better experience,” said Dr Soman.

The use of mid-level professionals is a growing trend, said Brown, especially in areas where there is a shortage of physicians. Their use does vary widely across the country, though, said Dr Soman, based on a combination of the market, “turf” issues, local politics, and state laws.

“Some state laws make it difficult for mid-level professionals to be used in clinics,” said Dr Soman.

Some HMOs also encourage visits to mid-level professionals instead of MDs, according to Brown, as visits to physician’s assistants and nurse practitioners are frequently less expensive than a visit to a doctor.

Patients are occasionally resistant the first time they see a mid-level professional instead of a doctor. But Dr Soman noted that patients with reservations usually only need a little education about physician’s assistants and nurse practitioners’ training and qualifications to put their minds at ease.

“Once patients establish a relationship with a mid-level professional they often become their preferred provider,” said Dr Soman. “They’re very popular with our patients.”.