Solving the physician shortage will require a team approach
A physician shortage could compromise patients' health and threaten the viability of practices, as an aging population increases demand for care and physicians retire faster than they are replaced.
Association of American Medical Colleges (AAMC) projections show that the United States faces a shortage of 54,100 to 139,000 physicians by 2033. The primary care physician shortage could be particularly acute, with 21,400 to 55,200 fewer physicians than needed by 2033.1
Fortunately, employing nurse practitioners and physician assistants offers options for future-proofing your medical practice despite the shortage. Bringing these providers onto your team can help you to treat more patients and engage with them more closely. This approach has the potential to support better care outcomes for patients as well as the financial performance of a practice, helping to alleviate the impact of the physician shortage.
How population & care trends have caused a physician shortage
The physician shortage is largely driven by the increasing gap between the number of aging patients and the number of available providers. The U.S. population of people 65 or older is projected to increase 45.1% by 2033, according to AAMC research into the complexities of physician supply and demand.2
As patients enter their senior years, they will need more healthcare. So, too, will people who cannot access care now: The lack of primary care can lead to serious health issues down the road.
Even today, many communities already cannot access care because there are not enough physicians nearby. Nearly 80 million people are living in federally designated health professional shortage areas (HPSAs) that experience challenges with prevention, screening, immunizations and basic care for infections and sicknesses.3,4 Some rural areas, for example, have more than 3,500 patients for each primary care provider.4
If populations that are underserved due to reasons like lack of health insurance coverage or poor access to providers were to engage in the same healthcare use patterns as populations with fewer barriers to access, current demand could rise by an additional 74,100 to 145,500 physicians, the AAMC says.5 However, success stories from some HPSAs point to a possible solution to the physician shortage in underserved communities in particular and for physician practices in general.
Nurse practitioners & physician assistances increase access to care
Nurse practitioners, who are trained in primary care, are helping to increase access to care for people in underserved HPSAs, according to Sophia Thomas, president of the American Association of Nurse Practitioners (AANP). Much of the increase in care in HPSAs are attributable to full practice authority, which enables nurse practitioners to practice to the top of their education and clinical training by not requiring them to be contracted to a physician.6
"From a patient perspective, we need to reimagine the healthcare system in this country and ensure that all Americans have access to primary care providers," Thomas says. "We want to improve access to care and, therefore, outcomes."
Already demonstrating an ability to improve access to care and outcomes for underserved communities, nurse practitioners could also alleviate the broader shortage of primary care physicians by assuming more responsibilities at practices, according to Heather Brom, an assistant professor at the M. Louise Fitzpatrick College of Nursing at Villanova University. Nurse practitioners and physician assistants reduce the workload on physicians.
For example, nurse practitioners help patients manage chronic diseases through preventive care, thereby reducing the number of hospital visits and decreasing the length of stays and readmission rates for any visits that do occur, according to Thomas.
Addressing the physician shortage by rethinking your practice staffing
The nation's 325,000 nurse practitioners handle 1 billion patient visits annually, diagnosing, treating and managing chronic and acute conditions in their practices, including prescribing medications.7 And, though the COVID-19 pandemic has increased physician retention challenges and prompted many physicians to retire early, it has also demonstrated how nurse practitioners contribute to the continuum of care.8,9
About seven of 10 healthcare leaders anticipate adding nurse practitioners to their practice in 2021 and 58% say their practice will add physician assistants.10 Collectively referred to as advanced practice providers (APPs), nurse practitioners and physician assistants provide clinical support.
As a growing physician shortage looms, nurse practitioners and physician assistants offer viable options for future-proofing your medical practice.
"You're seeing more nurse practitioners and physician assistants on teams at bigger practices," says Brom, an assistant professor at the M. Louise Fitzpatrick College of Nursing at Villanova University. "You're seeing more of their contributions to offsetting shortages in physician supply and increasing access to care."
Adding value & optimizing physicians' time with a team approach
Nurse practitioners add value to practices by allowing physicians to focus on more complex care. "If you have office space for both physicians and nurse practitioners in your practice, you can increase your panel of patients each day and distribute them based on severity, while leaving appointments for add-ons like sick visits," says Brom.
A certified nurse practitioner herself, Brom has also seen physicians free up time for research and surgeries by collaborating with nurse practitioners who would spend more time meeting with patients and following up on their visits, ensuring that they receive the treatment they need.
Supporting your practice's performance by diversifying your team
Nurse practitioners can help your practice grow as well, by helping to generate more revenue through a higher volume of patients, as suggested by Thomas. "You'll have an equal partner in care," she says.
Most clinical care provided by nurse practitioners or physician assistants is either directly billable, directly supports billable services or is in direct support of value-based care and population health performance measures that result in payments to a practice, according to the Medical Group Management Association (MGMA).10
More practices are using advanced practice providers like nurse practitioners and physician assistants as they recognize how APPs can improve practice performance, the MGMA says. MGMA research shows that almost 67% of top-performing practices and 87% of physician-owned practices use APPs.11
Overcoming the physician shortage by future-proofing your practice
Nurse practitioners and physician assistants are increasingly valuable to practices as the physician shortage intensifies. Though the COVID-19 pandemic has increased the demand for primary care, nurse practitioners and physician assistants have helped to maintain the health of patients and practices.
Adding nurse practitioners or physician assistants to your practice team can help make primary care more accessible to your patients while freeing physicians to focus on acute care, research or other needs. Decreasing your practice's dependence on physicians today would also position your practice to avoid challenges from the expected physician shortage ahead.
1: https://www.aamc.org/news-insights/press-releases/new-aamc-report-confirms-growing-physician-shortage
2: https://www.aamc.org/media/45976/download
3: https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation
4: https://www.aanp.org/news-feed/aanp-highlights-np-role-in-providing-accessible-rural-health-care-during-pandemic
5: https://www.aamc.org/news-insights/press-releases/new-aamc-report-confirms-growing-physician-shortage
6: https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
7: https://www.prnewswire.com/news-releases/more-than-325-000-nurse-practitioners-nps-licensed-in-the-united-states-301283369.html
8: https://revcycleintelligence.com/news/physician-retention-challenges-worsen-amid-covid-19
9: https://www.prnewswire.com/news-releases/findings-from-2020-survey-show-nurse-practitioners-nps-continue-to-provide-quality-health-care-during-the-pandemic-301266810.html
10: https://www.mgma.com/data/data-stories/medical-practices-look-to-clinical-support-staff-t
11: https://www.mgma.com/mgma-research-and-analysis/optimizing-advanced-practice-providers-in-heal-(1)
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