Date of Conferral



Doctor of Healthcare Administration, DHA


Health Services


Susanne Richins


Physician extenders as support in healthcare facilities has been increasing in the United States and has the potential to help in currently under served communities. This study evaluated the quality of care provided by physician extenders through the examination of average diagnosis and referral rates that may inform healthcare leaders and policymakers in future decisions. The literature review pointed to a gap in the research related to the quality of care based on patient diagnosis and referral rates by physicians and physician extenders. The conclusions were based on a quantitative analysis of secondary data from the National Ambulatory Medical Care Survey (NAMCS) with a sample size of 13,165 observations. A cross-sectional research design and quantitative analysis were used to undertake empirical investigations. The main statistical methods used for analyzing the data as well as testing the research hypotheses were descriptive analysis (i.e., statistics), linear regression, and Pearson correlation. The results of the empirical analysis indicated several things. First, a positive correlation between physicians and patient diagnosis and referral rates and a lack of correlation between these rates and physician extenders is seen. Also, a positive correlation between diagnosis rate and physicians and lack of significant correlation between diagnosis rate and physician extenders is noted. Lastly, the data indicating that a positive correlation exists between all providers and patient referral rates allows for the use of physician extenders to be eliminated as a possible constraint to quality of care. One implication for positive social change is to expand the use of regional or hub facilities managed and run by these physician extenders.