Objective: To evaluate factors associated with primary care physician attit
udes toward nurse practitioners (NPs) providing primary care.
Design:A mailed survey of primary care physicians in Iowa.
Setting and Participants: Half (N = 616) of the noninstitutional-based,full
-time, primary care physicians in Iowa in spring 1994. Although 360 (58.4%)
responded, only, physicians, with: complete data on all items in the model
were used in these analyses (n = 259 [42.0%]).
Main Outcome Measures: There were 2 principal dependent measures: physician
attitudes toward NPs providing primary care tan Ii-item instrument) and ph
ysician experience with NPs in this role. Bivariate relationships between p
hysician demographic and practice characteristics were evaluated by chi(2)
tests, as were both dependent variables. Ordinary least-squares regression
was used to determine factors related to physician attitudes toward NPs.
Results: In bivariate analyses, physicians were significantly more likely t
o have had experience with an NP providing primary care if they were in ped
iatrics or obstetrics-gynecology (78.3% and 70.0%, respectively; P<.001), h
ad been in practice for fewer than 20 years (P =.045), or were in practices
with 5 or more physicians. The ordinary least-squares regression indicated
that physicians with previous experience working with NPs providing primar
y care (P=.01), physicians practicing in urban areas with populations great
er than 20 000 but far from a metropolitan area (P =.03), and general pract
ice physicians (P =.04) had significantly more favorable attitudes toward N
Ps than did other primary care physicians.
Conclusions: The association between previous experience with a primary car
t NP and a more positive attitude toward NPs has important implications for
the training of primary care physicians, particularly in community-based,
multidisciplinary settings.