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There has long been a tradition in emergency departments — some might even call it a bias — of relying solely on physicians and nurses as the providers of medical care. Times are changing, however, and the use of mid-level providers, particularly Physician Assistants (PAs) and Nurse Practitioners (NPs), is allowing many EDs to bring new levels of efficiency and flexibility to their operations. Levels of Autonomy One of the keys to understanding the impact that mid-level providers can have on efficiency is their varying levels of autonomy in the course of providing care. For

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