NPs and PAs are at the center of the changing healthcare workforce

One of the things I love most about leading recruitment across physician and advanced practice specialties is having a front-row seat to how the healthcare workforce continues to evolve. 

Every day, Barton Associates work with healthcare organizations trying to solve the same challenge: making sure patients have access to quality care when they need it. Sometimes that means recruiting physicians. Sometimes it’s finding the right nurse practitioner or physician assistant. More often than not, it’s about building the right team.

When you look at the numbers, it’s easy to see why this conversation has become so important.

The Data Points to a New Care Model

More than 100 million Americans live in federally designated Health Professional Shortage Areas (HPSAs), where access to primary care, behavioral health, or dental services falls short of community needs. Nearly one in five Americans live in a rural community where the nearest hospital may be 30 miles away, with primary care often even farther away. Adding to the challenge, the Association of American Medical Colleges (AAMC) projects a shortage of up to 86,000 physicians by 2036, with some of the biggest gaps in primary care and psychiatry.

Those are significant challenges, but they also tell only part of the story. Another trend has been quietly reshaping healthcare.

According to the latest HRSA State of the Primary Care Workforce Report, there are now approximately 375,000 nurse practitioners working in primary care compared to roughly 340,000 primary care physicians.

To me, that isn’t a story about one profession replacing another. It’s a story about healthcare adapting.

The demand for care continues to grow, and healthcare teams have evolved alongside it. Physicians remain central to diagnosing complex conditions, performing specialized procedures, leading care teams, and advancing medicine. At the same time, NPs and PAs have become essential members of those teams, expanding access and helping patients receive timely, high-quality care.

We’re also seeing that reflected in workforce projections. While the AAMC projects physician workforce growth of roughly 3% over the next decade, employment for physician assistants is expected to grow 20%, and nurse practitioners 35%, according to the U.S. Bureau of Labor Statistics.

Those aren’t competing statistics. They’re evidence that healthcare needs every member of the care team.

The Gap Between “In Theory” and “In Practice”

The numbers tell an important story, but it’s what happens every day in healthcare settings across the country that really brings them to life.

In a small town in rural Mississippi, a federally qualified health center sees hundreds of patients each week. After its last physician retired, a nurse practitioner stepped in to keep care moving forward by managing chronic conditions, prescribing medications, and building the kind of long-term relationships that are at the heart of primary care.

In an urban emergency department in Phoenix, physician assistants manage lower-acuity patients with lacerations, fractures, and respiratory infections, allowing emergency physicians to focus on the most critical cases. Throughput improves, wait times drop and patients get home faster.

In a correctional facility in rural Ohio, a nurse practitioner serves as the primary care provider for more than 1,200 incarcerated individuals, a population with significantly higher rates of chronic disease and limited access to healthcare.

To me, these examples capture the real value of advanced practice providers.

They aren’t replacing physicians. They’re expanding access to care, strengthening healthcare teams, and helping ensure patients receive timely, high-quality care in communities that might otherwise struggle to meet demand.

The Persistent Misconception Worth Retiring

One of my favorite quotes on this topic comes from health economist Dr. David Chan in a recent TIME article examining the changing healthcare workforce:

“Increasingly, health care is about teams.”

I couldn’t agree more.

Research continues to support that approach. Studies published in the Annals of Internal Medicine have found that patients receiving primary care from NPs experience comparable outcomes in chronic disease management, preventive care, and patient satisfaction. A 2023 RAND analysis similarly found that PA-staffed emergency department models reduced patient length of stay without compromising safety.

Collaborative care allows every clinician to practice at the top of their education and training while giving patients greater access to care. Working in physician and advanced practice recruiting, I see this every day. The organizations finding the most success aren’t asking whether they need physicians or advanced practice providers. They’re asking how to build the strongest care teams.

Why Locum Tenens Is the Missing Piece

Locum tenens has become an important part of that strategy. Healthcare doesn’t pause because someone takes parental leave, retires unexpectedly, or because patient volumes spike during flu season. Vacancies can take months to fill permanently, especially once recruiting, credentialing, and onboarding are factored in.

Locum physicians, NPs, and PAs help bridge those gaps by maintaining continuity of care while organizations recruit for permanent positions.

For clinicians, locum tenens also creates opportunities that traditional employment doesn’t always offer: flexibility, exposure to new practice settings, geographic mobility, competitive compensation, and greater control over where and when they work.

What the Next Decade Actually Looks Like

Looking ahead, I think we’ll continue to see healthcare move toward even more collaborative models.

States continue to modernize practice regulations. Today, 28 states and Washington, D.C., grant full practice authority to nurse practitioners, allowing qualified NPs to evaluate patients, diagnose conditions, prescribe medications, and manage treatment independently within state law.

Physician assistants are evolving alongside those changes through practice modernization efforts that emphasize team-based care while reducing unnecessary administrative oversight. The expanding PA Licensure Compact is also making it easier for qualified PAs to practice across state lines and help address workforce shortages where they’re needed most.

To me, all of this points toward the same conclusion: the future of healthcare won’t be built by any one profession. It will be built by physicians, nurse practitioners, physician assistants, nurses, and countless other clinicians working together, each contributing their own expertise to deliver the best possible patient care.

Having spent more than a decade recruiting physicians, nurse practitioners, and physician assistants, I’ve had a front-row seat to this evolution, and it’s one of the most exciting changes I’ve watched unfold.

The strongest healthcare organizations I’ve worked with aren’t successful because they’re built around one profession. They’re successful because they’re built around great teams that recognize the unique value every clinician brings to patient care. 

At the end of the day, this conversation isn’t really about physicians, NPs, or PAs.

It’s about patients having access to the care they need, when they need it. And if we continue investing in collaborative care teams that allow every clinician to practice at the top of their education and training, we’ll be in a much stronger position to meet the growing healthcare needs of communities across the country.

FAQs

Are nurse practitioners and physician assistants in high demand?

Yes. Demand for both nurse practitioners (NPs) and physician assistants (PAs) continues to grow as healthcare organizations respond to physician shortages, an aging population, and increasing patient demand. The U.S. Bureau of Labor Statistics projects NP employment will grow 35% and PA employment 20% between 2024 and 2034, making them among the fastest-growing healthcare professions.

Why are NPs and PAs becoming more important to healthcare?

Healthcare organizations are facing growing demand for care while also navigating physician shortages, an aging population, and access challenges in rural and underserved communities. NPs and PAs help expand access, improve continuity of care, and allow healthcare teams to care for more patients while ensuring each clinician practices at the top of their education, training, and expertise.

Are NPs and PAs replacing physicians?

No. Healthcare is becoming increasingly team-based, and physicians, NPs, and PAs each bring unique training and expertise to patient care. Physicians continue to play an essential role in diagnosing complex conditions, performing specialized procedures, and leading care teams, while NPs and PAs help expand access to care by managing many acute and chronic health needs within their scope of practice.

Can nurse practitioners practice independently?

It depends on the state. Currently, 28 states and Washington, D.C. grant full practice authority to nurse practitioners, allowing them to evaluate patients, diagnose conditions, order and interpret diagnostic tests, prescribe medications, and manage treatment without physician supervision. Other states require a collaborative or supervisory relationship with a physician or use transition-to-practice models that expand autonomy after a period of experience.

Can NPs and PAs prescribe medication?

Yes. Both NPs and PAs have prescribing authority in every state, although the level of autonomy and any collaboration requirements vary based on state law and organizational policies.

What specialties hire locum tenens NPs and PAs?

Locum tenens opportunities exist across a wide range of specialties, including primary care, urgent care, emergency medicine, hospital medicine, behavioral health, occupational medicine, women’s health, and many medical and surgical subspecialties. Demand varies by specialty and location but continues to grow as healthcare organizations seek flexible staffing solutions.

Why are more healthcare organizations using locum tenens NPs and PAs?

Locum tenens allows organizations to maintain patient access during provider vacancies, leaves of absence, seasonal volume increases, and periods of growth. Rather than replacing permanent staff, locum clinicians help ensure continuity of care while organizations recruit and onboard long-term providers.

What is the PA Licensure Compact, and why does it matter?

The PA Licensure Compact is an interstate agreement that allows eligible physician assistants to practice more easily across participating states. As more states join the compact, healthcare organizations gain greater access to qualified clinicians, and PAs have more flexibility to pursue opportunities in multiple states, including locum tenens assignments.