Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. 361-369 (doi:10.1542/10.1542/peds.2006-1084)
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SPECIAL ARTICLE

Nonphysician Clinicians in the Neonatal Intensive Care Unit: Meeting the Needs of Our Smallest Patients

Eric W. Reynolds, MDa,b and J. Timothy Bricker, MDb

a Division of Neonatology
b Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky

Regional variations in the distribution of neonatal physicians and dependence on housestaff with restricted work hours have created workforce shortages in many NICUs. Although neonatal nurse practitioners assist in the delivery of high-quality care, availability of these providers may be inadequate in certain regions. Physician assistants represent a historically underutilized resource to resolve neonatology's workforce issues. We have developed a postgraduate training program for physician assistants in neonatology that we hope will improve local and regional workforce shortages. In this article we discuss the history of neonatal nurse practitioners and physician assistants in newborn care and outline the program that we developed. We further discuss some of the barriers we had to overcome in developing this program. Our program can serve as a model for other neonatology programs to adequately prepare physician assistants for a career in the NICU.

Key Words: neonatal nurse practitioner • physician assistant • alternative health care providers • neonatal intensive care

Abbreviations: NPC—nonphysician clinician • NP—nurse practitioner • NNP—neonatal nurse practitioner • PA—physician assistant • AAP—American Academy of Pediatrics • ARC-PA—Accreditation Review Commission on Education for the Physician Assistant • AMA—American Medical Association • NPA—neonatal physician assistant

Accepted Sep 29, 2006.


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