Vital Signs Blog

New solutions to primary-care access needed

Physician assistants and nurse practitioners increasingly are specializing and can't be counted on to provide the solution to the nation's shortage of primary-care providers, a report by the American Academy of Family Physicians concluded.

Even though they're often touted as a solution to filling in patient care gaps because of a shortage of primary-care docs, not enough PAs and NPs are working in primary care to make a difference, so policymakers need to come up with better solutions to address primary-care access, the researchers said.

Using data from the Agency for Healthcare Research and Quality, researcher Dr. Andrew Bazemore and his research term determined that 52.4% of 106,073 NPs work in primary care, while 43.2% of the 70,383 PAs work in primary care. Bazemore is the director of the Washington-based Robert Graham Center for Policy Studies in Family Medicine and Primary Care, which conducted the study.

“We are finding that the trends toward subspecialization we see among physicians are also occurring in the nurse practitioner and physician assistant communities,” Bazemore told MedPage today. “This finding corroborates recent federal studies of nurse practitioners and those of physician assistant organizations.”

“Although NPs and PAs may also benefit from factors that increase the likelihood of choosing primary-care careers, such as training experiences in rural and underserved communities, debt reduction and selection of students intent on caring for underserved populations, further studies are needed to know for sure,” the report read. “Relying on NPs and PAs to solve the problem of a growing shortage of primary-care physicians may not be an option, and policymakers should not abandon policy solutions designed to increase the number of primary-care physicians, NPs and PAs.”

MedPage also pointed to an online petition asking HHS Secretary Kathleen Sebelius to sponsor an Institute of Medicine study on PA utilization and effectiveness in terms of scopes of practice. The petition, as of Tuesday, had reached 612 of the 1,000 requested signatures.

“Despite over a half century of providing quality medical care, it is rare for these professionals to be allowed to practice as the full scope of their training and licensure,” the petition reads.

Follow Ashok Selvam on Twitter: @MH_aselvam


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