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Advanced practice nurses, Midlevel practitioners, Midlevel providers, Nurse practitioners, Physician assistants, Physician extenders



  1. Mikhail, Judy MSN, MBA, RN
  2. Millerz, William MS, PA-C
  3. Wagner, James MD


The purpose of this study was to evaluate our 23-year experience with midlevel practitioners in an American College of Surgeons-verified trauma surgery service in the absence of a surgical residency. A retrospective review of the utilization of trauma surgery midlevel practitioners was performed at a community hospital American College of Surgeons-verified trauma center from 1985 to 2007. The trauma surgery service has expanded in volume, acuity, and services offered over the 23-year period. This model has allowed us to establish effective and efficient surgical coverage while growing the trauma program, as well as general surgery and bariatric services.