Challenges of the 80-hour resident work rules: collaboration between surgeons and nonphysician practitioners

A Comparison of Fracture Reductions Performed by Physician Extenders and Orthopaedic Residents in the Acute Pediatric Orthopaedic Practice

“…There have been several studies looking at the role of physician extenders in several services such as family practice clinic, intensive care units, and general surgery trauma services, [6][7][8][9][10][11] but none looking at the quality of care rendered in the pediatric orthopaedic setting. Trauma accounts for one third of the work relative value units produced in both the outpatient and inpatient pediatric orthopaedic practice, yet a substantial component of treatment provided is of a complexity that can be handled by physician extenders.…”

Internal Medicine and General Surgery Residents??? Attitudes about the ACGME Duty Hours Regulations: A Multicenter Study

“…Although residents may be less fatigued at work and thus perform at a higher level, the redesign of residency training models after duty hours reform has forced teaching hospitals to care for the same number of patients with fewer resident physician-hours. Alternative solutions to the reduction in resident hours have been found through increased use of float models and physician extenders, 30 both of which introduce another practitioner to the care of a single patient and create a need for more patient hand-offs. Residents themselves have highlighted continuity of care as the area that has suffered the most as a result of the ACGME duty hours rules.…”

Non-Physician Practitioners’ Overall Enhancement to a Surgical Resident’s Experience

“…5 NPPs in surgery particularly are valuable in allowing residents operating room time. Studies have shown that NPPs decrease the workload of residents, 6,7 while providing benefits to patients and hospitals, including a shortened length of stay.…”