Will The Doctor Shortage Create Opportunities for Nurse Practitioners?
A recent New York Times article, “Doctor Shortage Likely to Worsen With Health Law” highlighted a problem facing many areas of the country — a lack of physicians, particularly primary care ones. According to the Times, “The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025…” Will this shortage which already exists today and looks to only worsen create opportunities and a demand for Nurse Practitioners? We think it will and here’s why…
The U.S. faces a huge health care crisis as the number of primary care physicians shrinks while the need grows vastly larger. As of 2008, 90% of medical school graduates chose better paying specialties with less paperwork and more status. It follows that less than half of the slots for primary care residencies in the U.S. are currently being filled. The shortage of these doctors will become even more critical as the ‘tsunami wave’ of baby boomers requires increasing care as they reach old age. And in 2014, the situation will become compounded by the millions of people added to managed-care rolls as health reform legislation takes effect.
As health care providers scramble to find a solution to the problem of treating more patients with fewer available general practice doctors, many agree that one logical remedy lies in expanding the role of advanced practice nurses. By allowing them to take over more physician functions, like independently examining patients, ordering and interpreting medical tests, prescribing medication and admitting patients to the hospital, the shortage can be significantly alleviated. Another plus is a reduction in health care costs; the Medicaid reimbursement for nurse practitioners is 85% of what primary care doctors garner for the same services.
There are incentives in place to increase the ranks of graduating general practice physicians, but even if this tactic works, the time frame for putting them into service is ten or so years down the road. Training nurse practitioners on the other hand, is quickest and least costly way to increase the ranks of desperately needed caregivers. Current estimates show that for the cost of training one doctor, as many as 12 nurse practitioners, most of whom have several years of clinical experience already from working as RNs, can be educated.
The new federal health care reform legislation supports enlarging nurse’s roles in health care, having listed nurse practitioners and physicians’ assistants in the same category as primary care doctors, something that was lobbied for by many nursing organizations.
The American Medical Association is among the physicians’ organizations pushing back on expanding nurse’s roles, saying that the traditional physician-led paradigm should stay in place and that nurses are not interchangeable with physicians. Nursing advocates say that this kind of ‘turf war’ defensiveness is not unexpected, as doctors feel threatened by the expanding the autonomy of nurses.
In addressing a convention of nurse practitioners, Becky Patton, President of the American Nurses Association said, “Allowing APRNs [advanced practice RNs] to simply do what they have been educated and trained to do benefits patients by providing them with increased access to affordable, high-quality health care. If this is not the overarching objective of health care reform in this country, it should be.”
As they so often do, nurses are ready to come to the rescue. But ultimately it’s up to state legislators to pass laws expanding their autonomy so they can do so.
We have no doubt that nurse practitioners are very well suited to help address the need created by the shortage of primary care physicians.
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