Primary care services are struggling right now to find enough qualified physicians to provide treatment. Factors like increased healthcare coverage in the U.S. are adding to the severe need for these specialists. So what is the magic solution to this need for more professionals capable of giving seeing patients for minor visits? It may actually become a matter of state policy.
The debate rages on. On one side of the fence, some argue that only physicians are qualified to care for patients and that allowing advance-practice nurses to take on their duties is risky business. After all, physicians do attend school an average of 12 years, whereas NPs only have about six. However, some studies suggest that nurse practitioners are fully capable of providing primary care. Furthermore, allowing them more freedom in their practice would solve growing healthcare shortages.
Nurse Practitioners Curing Primary Care Shortages
Nurse practitioners are advance-practice nurses that have obtained further education, usually their master’s degree. So when the shortage of physicians were expected to increase with the increase of the insured population, the solution provided was to start allowing more freedom to practice medicine by both NPs and and physician assistants. And, for decades NPs have been pursuing the practice freedom that wasn’t given to them really until the affordable care act came about.
In 2012, we were seeing 18 states that allowed for nurse practitioners to examine, diagnose, and prescribe medications to primary care patients. Around the same time, we began noticing that new grads fresh out of medical school had little interest in doing primary care. A lot of people were beginning to also feel like physicians were overqualified for that type of practice. All of this happens while our country continues to face an aging population in dire need of these services in the near-future.
Currently, 20 states have regulations that allow nurse practitioners to provide primary care without the supervision of physicians. “Scope-of-care” laws are rapidly enabling NPs to be able to take care of patients with chronic illnesses, providing immunizations and screenings, examination rights and capacity to diagnose patients. Initial care and preventative medicine could be administered to a great deal of more people if non-physician practitioners are given opportunities to do so.
However, some policy makers are not supportive of allowing non-physicians to conduct primary care services. They propose implementing incentives to physicians for practicing primary care to make it more appealing in attempt to fill some of the shortage gap. Additionally, some feel that only physicians should be able to provide those types of treatments without supervision because of possible health risks. One argument is that doctors receive more hands-on training in one year than an entire school career of a nurse practitioner.
On the other hand, some studies have shown that the outcomes of primary care treatments comparing physicians and NPs were remarkably similar. In fact, some research has shown NPs actually provided better care to patients in regards to following-up, time spent in consultation, and attention during screenings. And, when considering the length of time in school to obtain NP-status it is about half of a physician; it would only make sense to fill these workers in these jobs if they truly are capable of doing equal (or better) work. Additionally, if nurse practitioners provide these services it is cheaper than being done by physicians because they do not get paid as much.
While no one is suggesting that nurse practitioners replace the role of a physician, perhaps the way to battle a crippling shortage of staff is to allow more freedom in their scope of practice. We will see what the future holds for this debate as more and more state review bills alter current regulations in the matter.