It's becoming much more common for non-physicians to provide care at the doctor's office.
Use of nurse practitioners, physician assistants and other "non-physician providers" increased more than 40 percent between 2010 and 2014 at certain physician-owned surgical practices, according to a national survey released Thursday.
Multispecialty and primary care practices owned by doctors also reported increases, as did all types of clinics owned by hospital systems, according to the report from the Medical Group Management Association.
Practice managers say non-physician providers help boost a clinic's efficiency by letting physicians concentrate on patients with more complicated needs.
"When I started working in medicine in the 1980s, it was rare to see a nurse practitioner or physician assistant in a clinic," said Laura Palmer, senior fellow with Medical Group Management Association, which is a trade group for medical practice administrators and executives. "Now, it's unusual not to see them."
The category of "non-physician provider" goes beyond nurse practitioners and physician assistants to include a variety of professionals, from midwives and psychologists to clinical social workers and physical therapists.
Most have a master's degree level of education, and some work under the direct supervision of a physician.
Overall, physicians still provide most of the care. But the report released Thursday found that physician-owned surgical practices that specialize in one branch of medicine employed 0.85 non-physician providers for every full-time doctor in 2014. That was up from a ratio of 0.59 non-physician providers per full-time physician in 2010 at those clinics.