The Physician Shortage Crisis and the Expanding Roles of NPs, PAs

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Courtesy-Steve-MoorAs healthcare executives, you may be attempting to manage in-house resistance from your physicians over the increasing responsibilities that are being given to nurse practitioners and physician assistants.

Many news organizations have reported on the fight physicians are waging against this trend, but Fatimah Waseem of USA Today reports that you may have another group on your side: healthcare consumers, who are slowly getting used to the idea of receiving care from physician assistants and nurse practitioners.

According to a study conducted by the Association of American Medical Colleges, “About half of U.S. consumers prefer physicians for primary healthcare, but patients are willing to see physician assistants and nurse practitioners to secure timely access to care.”

Part of the study dealt with how long patients were willing to wait in order to be seen for something like a cough. One-quarter of the respondents said they’d rather wait an extra day if it meant treatment by a physician, but nearly 60 percent said they’d accept treatment by a physician assistant or nurse practitioner if they could get in on the same day.

However, Waseem recalls a 2012 survey from the American Medical Association that directly contradicts this study. “In that survey, three out of four patients said they prefer to be treated by a physician even if it takes longer to get an appointment and costs more.”

The AMA, not surprisingly, advocates “a physician-led team approach to care,” but Darrell Kirch, president and CEO of the medical colleges association, said, “We need to focus on building our capacity to train physicians while also embracing the roles in which other professionals can serve.”

Necessity may render this ongoing back-and-forth useless, since the roles of nurse practitioners and physician assistants are becoming even more vital in healthcare as the physician-shortage crisis worsens and healthcare reform enables more patients to enter the system. The medical colleges association predicts physician shortages will hit 90,000 by 2020, Waseem writes.

Furthermore, the 65-and-older population “is expected to double by 2060” and that’s “the segment of the population most in need of healthcare.”

Whether they like it or not, physicians may have to embrace PAs and NPs in order to continue providing high-quality care to their patients and managing their populations. Another study, in fact, this one from the Journal of the American Board of Family Medicine, found that more doctors are actually using PAs and NPs as time goes by.

According to Waseem, “About 60 percent of family physicians collaborate with physician assistants and nurse practitioners to care for patients, suggesting this team-based approach may ‘help alleviate patient access to healthcare issues.’”

As healthcare executives, have you struggled with physician acceptance of nurse practitioners and physician assistants to the team? What about your patients: have they accepted care administered by NPs and PAs? What are your feelings on giving these healthcare professionals increased responsibilities over patients?

-by Pete Fernbaugh

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