The Burlington Randomized Trial of the Nurse Practitioner

TLDR

A randomized controlled trial conducted from July 1971 to July 1972 in a suburban Ontario family practice evaluated the impact of replacing physicians with nurse practitioners in primary‑care delivery. Patients receiving conventional physician care were compared before and after the trial with those receiving care primarily from nurse practitioners, assessing health status changes. Mortality, physical, social, and emotional functioning, quality of care, and patient and professional satisfaction were similar between groups, while the nurse‑practitioner model was cost‑effective for society but not financially profitable for doctors due to reimbursement limits. N Engl J Med 290:251–256, 1974.

Abstract

Abstract From July, 1971, to July, 1972, in a large suburban Ontario practice of two family physicians, a randomized controlled trial was conducted to assess the effects of substituting nurse practitioners for physicians in primary-care practice. Before and after the trial, the health status of patients who received conventional care from family physicians was compared with the status of those who received care mainly from nurse practitioners. Both groups of patients had a similar mortality experience, and no differences were found in physical functional capacity, social function or emotional function. The quality of care rendered to the two groups seemed similar, as assessed by a quantitative "indicator-condition" approach. Satisfaction was high among both patients and professional personnel. Although cost effective from society's point of view, the new method of primary care was not financially profitable to doctors because of current restrictions on reimbursement for the nurse-practitioner services. (N Engl J Med 290:251–256, 1974)