Physician dissatisfaction with ACA presents opportunity for midlevel providers

Change is on the horizon for the world of medicine. Recent legislation, namely the Affordable Care Act (ACA), promises sweeping and massive reform to the system in which we work. Many physician groups have spoken out against the ACA expressing dissatisfaction with the changes it poses to their careers and fear for the future of healthcare. While some doctors expect healthcare reform to negatively impact their future, how will the ACA affect nurse practitioners and physician assistants? So called Accountable Care Organizations (ACO), an attempt to coordinate medical care and cut healthcare costs under the ACA, are cropping up across the country. Some physicians are wary of this new format of medicine as it relies on evidence-based protocols and greater discretion in ordering expensive procedures and testing. This model doesn’t fit with the way many physicians have been trained, putting them at odds with the ACO approach to providing healthcare. Midlevel providers, however, are educated with evidence-based protocols and cost-effective care in mind, making them the natural fit for participation in this model of care. Concerned with increasing regulations and decreasing Medicare payments, physicians are retiring at increasing rates. Over 60 percent of physicians said they would retire today if they had the ability to do so. While doctors plan their exodus from the medical field, 32 million more Americans will become insured under the ACA. Midlevel providers are perfectly positioned to assume care for these millions of Americans who will need medical care as a result of decreasing physician numbers and increasing accessibility of health insurance. Educating midlevel providers requires less time and money than training physicians making these careers easily obtainable. The job market for midlevel providers promises to grow as larger numbers of providers are needed. Along with increasing availability of jobs, the ACA will spur an increased scope of practice for midlevel providers. Nurse practitioners and physician assistants assuming care for a greater number of patients will motivate legislators to ease regulations governing midlevel providers. Currently, 16 states allow nurse practitioners to practice independently. Experts anticipate this number will increase in the coming years allowing NP’s to help alleviate the physician shortage. Regardless of your personal political opinions, the impending changes in medicine promise increasing opportunities for midlevel provides. Nurse practitioners and physician assistants are trained in a protocol-driven style of practice making them a natural fit for participation in Accountable Care Organizations. They are open to the concept of practicing in cost-saving venues such as retail health clinics. The streamlined educational path of midlevel providers will allow for training of larger numbers of individuals to carry the burden of the increasing number of insured Americans. The ACA, whether a positive or negative for our country’s medical system, promises to positively affect the careers of nurse practitioners and physician assistants.