We additionally find that Medicaid expansion is associated with a 34.5% increase from 2013 in the probability of having an office-based
midlevel provider visit, which may include some visits to nurses.
However, under the new arrangements and care models,
midlevel providers provide more independent medical services, which will increase their own direct risk to medical malpractice cases as well as of the risks of those that are supervising and responsible for the care.
* Specialists depend on
midlevel providers for monitoring and follow-up even in complicated medical cases, expecting them to alert the specialists to drug reactions, drug toxicities, and other complications that often exceed the
midlevel provider's expertise.
According to the Institute of Medicine, trained
midlevel providers can deliver primary care services--from wellness and prevention services to the management of chronic disease--at least as safely and effectively as physicians.
When the hospital, by its actions or inaction, leads patients to believe that a physician, therapist, or
midlevel provider is employed by the hospital, courts have applied agency law principles to hold the hospital responsible for the provider's conduct, as if the provider were an actual employee.
In September 2012, Washington State legislation passed "a supervised extender as an alternative to the dental
midlevel provider legislation (AFDA)" as contemplated by other states.
Midlevel provider in menstrual regulation, Bangladesh experience.