Do physicians still direct nursing workforce? A profession striving for autonomy since mid- 1900’s

Abstract

Abstract Background This study highlights the contribution of nurses is secondary to physicians to overall population health (indexed with life expectancy at birth, e(0)). Methods All data were extracted from the World Bank. The potential competing effects of affluence, urbanization and obesity were fully considered when scatter plots, bivariate correlation and partial correlation models were performed to analyse the correlations between e(0) and physician healthcare and nursing healthcare respectively. The Fisher Z-Transformation was conducted for comparing the correlations between e(0) and physician healthcare and nursing healthcare. Multiple linear regression analyses were implemented for modelling that physicians’ contributions to e(0) explain nurses’. Results Physician healthcare correlates to e(0) significantly more strongly than nursing healthcare (z= 2.83, 2.95 and 2.01 in scatterplots, Pearson’s r and nonparametric respectively, p< 0.05). Physician healthcare remains significantly correlational to e(0) when nursing healthcare alone was controlled or when the 3 confounders (economic affluence, obesity and urbanization) were controlled (r=0.380, p <0.001 and r=0.444, p < 0.001 respectively). Nursing healthcare was in weak or negligible correlation to e(0) when physician healthcare was controlled individually or together with the 3 control variables. Linear regression reveals that nursing healthcare was a significant predictor for e(0) when physician healthcare was “not added” for modelling, but this significance became negligible when physician healthcare was “added”. Conclusions Physician healthcare correlated to e(0) extension significantly more than nurses. Statistically, physicians may explain the role of nurses in extending e(0).