Nurses provide patient care on par with physicians, and sometimes better: study

Nurses perform some health care services just as well as doctors, and in some cases, they outperform physicians, according to results of a new meta-analysis of hospital care.

The authors of “Substitution of nurses for physicians in the hospital setting for patient, process of care, and economic outcomes,” analyzed 80 studies covering 28,041 patients. They were treated by specialist nurses, advanced nurse practitioners and registered nurses substituting for junior and senior physicians across a range of specialties.

“In our review, we found little to no difference between nurse‐physician substitution and physician‐led care,” the authors concluded. “Although nurse‐physician substitution may result in better outcomes in certain cases, the evidence is uncertain. In considering nurse‐physician substitution as a solution to physician shortages, we also need to consider its impact on the nursing workforce.”

There was little to no difference in deaths, safety events or how patients felt about their health, according to a news release about the meta-analysis.

“Our findings show that nurse-led services provide care that is just as safe and effective as doctor-led services for many patients,” lead author Michelle Butler said in the news release. Butler is a professor at Dublin City University in Ireland. “In some areas, patients actually experienced better outcomes when nurses led their care.”

Nurses topped physicians in areas such as diabetes control, cancer follow-up and dermatology. Doctors had the edge over nurses for specialties involving sexual health and medical abortion follow-up services.

Not enough doctors — a global problem

The authors noted that health care systems across the globe are under pressure because of aging populations with complex health needs, long waits to see a doctor and physician shortages. The analysis was based on studies from around the world, with the most (32) from the United Kingdom.

Nurses may be able to take on more responsibilities for services, treatments and tasks. Examples include taking patient histories, conducting physical examinations, ordering tests, prescribing medications and providing patient education.

The authors noted there is a wide range of models for substituting nursing care for physician care. There are additional differences in levels of nurse training, responsibility and supervision, all of which can influence patient outcomes.

“In some cases, patients had earlier, more frequent, or on-demand appointments with nurses, or had an additional educational component to their care, which may have helped to improve their outcomes,” Butler said in the news release.

A cure for health care issues?

Simply swapping doctors for nurses is not a cure-all for the problems of health care systems, the authors said. Expanding nurse care has its own issues, not least the training of nurses, the news release noted.

“Nurse substitution isn’t simply a one-for-one replacement,” senior author Timothy Schultz said in the news release. Schultz is a researcher from Flinders Health and Medical Research Institute in Australia. “To work well, these services need the right training, support and models of care, but the evidence shows patients are not disadvantaged and can benefit in meaningful ways.”

Expanding nurse-led services may help address doctor shortages, but the authors urge policy makers to consider the impact of these interventions on the nursing workforce, including training and organization.

The study was published on Feb. 12, 2026, in the Cochrane Library. Additional authors were Marcia Kirwan, Vera J.C. McCarthy and Judith A. Cole.