Nearly all nurse practitioners and physician assistants practice in physician-led teams, and findings from a new AMA survey show the vast majorities of both are quite happy to be working this way.
This new data—based on a national survey of 502 nurse practitioners and 500 physician assistants last year—was unveiled at the 2026 AMA State Advocacy Summit, held this year in Southern California. The findings affirm the critical role of physician leadership in delivering high-quality, safe patient care.
According to the AMA issue brief on nurse practitioners' views of physician-led care (PDF), 95% reported practicing on a physician-led team, and 88% said they are satisfied, with over half stating they are very satisfied.
As for the views of physician assistants (PDF), all of them reported working on a physician-led team, and 94% said they are satisfied, with 60% saying they are very satisfied.
Both groups of nonphysician providers cited collaboration on complex cases, mentorship, liability protection and patient safety as significant benefits.
According to separate AMA survey results released at the summit, 89% of the state medical association and national medical associates government affairs staff surveyed named scope of practice as their No. 1 priority this year.
As part of its long-running efforts to fight scope expansions, the AMA defends the practice of medicine against scope of practice expansions that threaten patient safety and undermine physician-led, team-based care.
Not what you expected? Here’s why
“What we've seen on the ground in our state of Mississippi is that there is a lot of pressure from trade associations on some nonphysician providers—who enjoying collaborating and being on a physician-led team—to not speak up,” said Jennifer Bryan, MD, a Mississippi family physician, in an interview with the AMA.
Dr. Bryan is a member of the AMA Council on Science and Public Health and vice chair of the Mississippi delegation in the AMA House of Delegates.
“The average nurse practitioner or physician assistant likes having that malpractice cushion, the expertise cushion with somebody to ask about difficult cases, the collegiality. These people are out there and they fear being left alone,” said Dr. Bryan. She also took part in an AMA State Advocacy Summit panel discussion that touched on the results.
Dr. Bryan and her co-panelists experts unpacked what the trends mean for the practice of medicine, including the risks posed when health professionals without specialty training rapidly shift into new fields—with one in three nurse practitioners and physician assistants reporting that they have switched their specialty at least once.
A majority of states allow nurse practitioners to practice without physician supervision or collaboration in 27 states and the District of Columbia.
“Hospitals may hire a nurse practitioner and then say, ‘Here in this state, you're allowed to practice independently, so we're not going to get you a collaborating physician.’ Well, that's not right,” Dr. Bryan said.
Facts of the matter
The AMA’s survey shows that nurse practitioners and physician assistants realize the value that physicians bring as the leaders and mentors on the health care team.
“Training matters, expertise matters. The data, when you look at it, very plainly says that care is less expensive and a better value under the supervision of a physician. It's safer care,” Dr. Bryan said.
“The trade associations are out of touch with what their membership wants,” she added. “That is the only way I can interpret it from my lived experience and from what the data shows.”
Nurse-practitioner programs generally last two to four years, although some NPs can get a degree in as little as 18 months after becoming an registered nurse. Physician-assistant programs typically run two to two-and-a-half years. Neither nurse practitioners nor physician assistants have a residency-training requirement.
Physicians, by contrast, typically complete four years of medical school to earn a degree as an MD (doctor of medicine) or a DO (doctor of osteopathic medicine), and they have to complete an additional three to seven years of residency and fellowship training, depending on the specialty they pursue.
Nurse practitioners get just 500–750 patient-care hours and physician assistants only about 2,000 hours of supervised clinical practice in their master’s level training. Compare this with the 12,000–16,000 hours of patient-care experience that physicians amass between clinical rotations and residency training.
Learn more with the AMA about what sets apart physicians and nonphysicians.
Referral patterns a problem
One of the upshots of these differences in training is what Dr. Bryan sees as excess referrals by nonphysician providers in primary care.
“Generally speaking, if a physician is referring, the patient needs to be referred,” Dr. Bryan said. “But sometimes you get people who have 18 months or so of training and they're young, they're not experienced, and they say, ‘I don't know what to do with this, so I'm going to refer.’”
Now that training gap is also a factor in specialty care, as the AMA survey data shows. And when nurse practitioners and physician assistants do switch specialties, they often do so without any formal training in the new specialty, instead relying on physicians to provide on-the-job training. This underscores the vital importance of maintaining physician-led care.
Through its Advocacy Resource Center, the AMA works directly with national, state and specialty medical societies to enact state laws and regulations that protect patients and support physicians—and fight back against those that do not.
