With the United States facing a physician shortage, especially in primary care, nurse practitioners (NPs) and physician assistants (PAs) are stepping up to provide services to more and more patients Let’s take a look at some facts about these providers that you may not have known.
Their Numbers Are Growing
While the number of physicians is shrinking, the number of NPs and PAs is growing. The American Association of Nurse Practitioners (AANP) estimates there are more than 189,000 nurse practitioners practicing in the U.S. — double the number practicing in 2003. The AANP also estimates 14,000 NPs completed their academic programs in 2011-2012 alone.
The American Academy of Physician Assistants (AAPA) reports there are more than 95,000 physician assistants working in the U.S. A report published in Public Health Reports predicts that the physician assistant workforce will grow 72% between 2010 and 2015.
Their Job Opportunities Are Growing
Survey research conducted by the American Medical Group Association shows that two-thirds of organizations increased their advanced practice clinician (APC) workforce, which includes NPs and PAs, within the past 12 months. That same percentage also expects to increase their APC workforce in the next 12 months.
A recent report from the Bureau of Labor and Statistics also projects that between 2012 and 2022 NP and PA jobs will grow 31% and 38% respectively.
Locum tenens opportunities are also growing. The percentage of organizations that used locum tenens nurse practitioners nearly tripled between 2012 (4.8%) and 2013 (12.35%). Use of physician assistants nearly doubled in the same time period jumping from 2.8% to 6.47%.
Their Scope of Practice Varies by State
State law dictates what medical services PAs and NPs can provide, how autonomously they can practice, and what medications they can prescribe.
Currently, laws in 18 states allow nurse practitioners to practice independently, without physician oversight, meaning they can open their own practices, prescribe controlled substances, and practice to the extent of their training. For more information on NP scope of practice laws, check out our interactive scope of practice tool.
All physician assistants require physician supervision; however, the level of supervision required varies by state. For example, some states require the supervising physician be physically present when PAs provide service, while others only require a physician be available via telephone. For more information on state PA scope of practice laws, check out the AAPA website.
They Provide Care That Is Comparable to Physicians'
There is a growing body of evidence that shows NPs and PAs provide high quality care, and in some cases care that is equal to the quality provided by physicians. In fact, an article that appeared in the April 2010 issue of the Journal of the American Academy of Nurse Practitioners stated that “of more than 100 published, post-OTA reports on the quality of care provided by both nurse practitioners and physicians, not a single study has found that nurse practitioners provide inferior services within the overlapping scopes of licensed practice.”
NPs and PAs also receive, on average, favorable patient satisfaction scores.
They Are More Likely to Work in Underserved Areas
About 20% of Americans live in rural areas, but only 9% of physicians practice there, according to Dr. Howard Rabinowitz, a professor of family and community medicine at Thomas Jefferson University’s Medical College.
On the other hand, 17% of PAs and 18% of NPs practice in rural areas. In fact, many NPs have established successful nurse led community centers in rural and underserved areas. A recent article published in the Journal of Health & Human Services also shows that PAs have been successfully used to expand healthcare services within an urban community.
They Are Not Looking to Replace Doctors
Although there are many articles written that advocate more autonomy for NPs and PAs, these providers should not be viewed as a threat to physicians.
Opponents of increased NP and PA autonomy often argue that it may drive physician practices away from their state or reduce physician salaries. In fact, studies have shown physician salaries are on par and in some cases better in states that have favorable NP and PA scope of practice laws.
More importantly, states that allow NPs and PAs the ability to practice to the top of their education are better prepared to implement integrated healthcare systems and provide comprehensive care to their citizens.
They Work Well With Others
Initiatives such as Accountable Care Organizations and patient-centered medical homes have placed greater emphasis on providing patient care via multi-disciplinary care teams. NPs and PAs have proven to be invaluable members of those teams. Because they are capable of performing many of the routine services physicians typically render, physicians are able to delegate some of their responsibilities to NPs and PAs, allowing them to treat more complex cases.
They Work in Nontraditional Settings
The growth of retail clinics, onsite corporate health clinics, and in-home healthcare companies has created opportunities for NPs and PAs outside the traditional hospital or doctor’s office. As the healthcare industry continues to evolve to meet the physician shortage, NPs and PAs will find even more opportunities to provide care to patients in a variety of settings.