As Health Care Reform continues to roll out and coverage expands in 2014, the projected shortage of physicians begs the question: who will provide care to the millions of newly insured Americans? The Association of American Medical Colleges projects that the United States will have a physician shortage of 91,500. In addition to the actual physician, both physician assistants and nurse practitioners play an instrumental role in providing health services to the population.
Clese Erikson, the Director of the Association of American Medical Colleges’ Center Workforce Studies, surveyed 2,000 patients who received medical care within the past year to determine which type of medical provider patients would like to receive follow-up care from. The graph below shows results from the respondents:
The data illustrates how preferences changed as wait-times for follow-up appointments increased. If a doctor was available the same day, most patients preferred a physician. However, if patients had to wait one to three days for follow-up care by a physician, preferences favored a nurse practitioners and physician assistants.
By separating the data by age groups, Erikson’s research reveals how age plays a role in how a patient determines the type of medical provider preferred. The results (illustrated in the graph below) suggest that older individuals prefer to be seen by a physician rather than a nurse practitioner and physician assistant.
With the expected increase of the newly insured population in 2014, further efforts to expand scope of practice laws would be useful in helping to remedy capacity problems and treat patients in a timely matter.
California’s Legislature is currently considering this effort under the proposed SB 491, SB 492 and SB 493 (Hernandez), which would allow providers to expand their scope of practice. The trio of bills would give nurse practitioners, optometrists, and pharmacists (respectively) the option to practice independently, and with less or without physician oversight. According to the National Conference of State Legislatures, 144 bills have been proposed to expand scope of practice laws in the U.S. Advocates who are in favor of expanding the scope of practice laws recognize that nurse practitioners and physician assistants could fill the growing primary care shortage more quickly due to their knowledge and training in the area.
To access other workforce data and reports from the Association of American Medical Colleges, click here.