PEDIATRICS Vol. 55 No. 5 May 1975, pp. 700-708
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The Modification of Pediatrician Activity Following the Addition of the Pediatric Nurse Practitioner to the Ambulatory Care Setting: A Time-and-Motion Study

Lawrence Kahn M.D.1 and Patricia Wirth B.A.1

1 Edward Mallinckrodt Department of Pediatrics and the Division of Health Care Research, Washington University School of Medicine, St. Louis, Missouri

Time-and-motion studies were performed before and after PNPs began working in the offices of three pediatricians and the emergency room of a municipal general hospital. Pediatricians' activities changed in different ways, but all benefited by the generation of available time. The three pediatricians in office settings gained the equivalents of 21.6%, 21.7%, and 36% of the working day by the addition of the PNP. Physicians working in the emergency room gained 14.7% during that time of day the PNP was present. PNP visits with patients were longer than those of the pediatricians, the average length of time being related directly to that of the associate physician. Patients interviewed perceived no difference in personal characteristics between pediatricians and PNPs in three of the four settings. In the fourth setting, both were at high levels, but the pediatrician ranked higher than the PNP.

Submitted on July 18, 1974
Accepted on September 18, 1974




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