February 3, 2019- It’s no secret, the healthcare industry is facing a primary care physician shortage that’s not getting better anytime soon. Leaning on non-physician clinicians such as nurse practitioners (NPs) could reduce the enormity of that problem, according to a recent report from the United Health Group (UHG).
Currently, 13 percent of US patients live in a county with a primary care shortage, defined as having less than one primary care physician (PCP) per 2,000 patients.
The shortage impacts both rural and urban areas, although its effects are more concentrated in rural areas. However, the number of patients living in urban or suburban areas experiencing a provider shortage is nearly equal to the number of patients living in rural areas experiencing the same thing – 21 million patients versus 23 million, respectively.
As time wears on, PCPs are going to age into retirement. By 2025, one-third of the providers practicing today will be over age 65 and will be preparing for retirement.
Unfortunately, there is little primary care interest among new graduate student classes, the UHG report continued. In 2017, only one in six medical school graduates chose a primary care residency.
These disparities mean current PCPs will need to work extensive hours to treat their patients. A PCP with a typical patient panel of 2,000 patients will need to work over 17 hours each day to deliver the requisite level of primary care, chronic care management, and acute care.
The doctor shortage is not the only problem. Patient demand for primary care is also increasing.
By 2030, demand for primary care will increase by 38 percent among the over-65 population, and by 55 percent for the over-75 crowd. For all age groups, demand will increase by 8 percent.
Non-physician clinicians, such as nurse practitioners and physician assistants, are well-positioned to address the physician shortage in primary care. These professionals undergo extensive training, with NPs focusing on disease prevention and health management, two core tenets of primary care.
What’s more, NPs have a documented interest in primary care. Seventy-eight percent of nurse practitioners – 204,000 out of 262,000 – practice primary care, a far cry from the 33 percent of physicians choosing the same specialty.
However, some obstacles exist for fully tapping NPs to fill primary care gaps. Currently, only 22 states grant NPs full scope of practice, meaning that nurse practitioners can practice to the top of their training unsupervised. Sixteen states, Ohio included, allow NPs some practice autonomy, but enforce limits such as prescribing medications only in certain quantities.
Following expansion of NP scope of practice, the number of patients living in a county with a PCP shortage would go down from 44 million to 13 million nationwide. In rural regions, that proportion would decrease from 23 million to 8 million, a near 65 percent reduction.
At Staunton Primary Care, we strive to provide value-based care, patient wellness, and preventive care.