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In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients' outcomes were comparable.

This study reports results of the 2-year follow-up phase of a randomized study comparing outcomes of patients assigned to a nurse practitioner or a physician primary care practice. In the sample of 406 adults, no differences were found between the groups in health status, disease-specific physiologic measures, satisfaction or use of specialist, emergency room or inpatient services. Physician patients averaged more primary care visits than nurse practitioner patients. The results are consistent with the 6-month findings and with a growing body of evidence that the quality of primary care delivered by nurse practitioners is equivalent to that by physicians.

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This study provides preliminary evidence of interdisciplinary differences in the processes of care employed by primary care NPs and MDs in caring for patients with type 2 diabetes. NPs documented the provision of diabetes education and selected monitoring tests more frequently than MDs; however, these differences were not reflected in 6-month patient outcomes.

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Guidelines recommend that patients with persist- ent seizures not responsive to standard antiepileptic drugs after 1 year be referred to specialized epilepsy centers for evaluation, which may include inpatient video-electroencephalographic monitoring. This 1-year retrospective, limited-focus review of 213 admissions and 3-year postdischarge review of epilepsy surgery referrals sought to determine if admission to an inpatient adult epilepsy monitoring unit resulted in a definitive diagnosis, a change in diagnosis or treatment, and whether referral patterns were consistent with guidelines. The median duration of time since symptom onset prior to admission was 15 years. At discharge, 87.8% of admissions received a definitive diagnosis. Epilepsy was diagnosed in 73.3% and excluded in 21.6%. Admissions without epilepsy had been treated with antiepileptic drugs for a median of 9 years. Admission resulted in change in treatment in 79%. This review documents the diagnostic utility of an epilepsy monitoring unit while highlighting that time since symptom onset to admission exceeded established guidelines.