I got off on a tangent somehow this morning. In the midst of preparing for a continuing education presentation, my Googling got off track and click, click, click, I landed on an article totally off the topic of ‘prescribing considerations in primary care’. The New England Journal of Medicine’s Rethinking the Primary Care Workforce – An Expanded Role for Nurses shared some compelling statistics about the future of healthcare delivery in our country. Since these stats were interesting enough to divert my attention this morning, I felt compelled to share them.
As nurse practitioners, most of us have heard about the so-called primary care shortage in our country. Our population is aging, and with it the demand for healthcare resources increasing. Healthcare reform through the Affordable Care Act provided health insurance to millions more Americans furthering the demand for primary care services.
Most articles I have read about the topic focus on the number of physicians the United States lacks to cover this need for healthcare. Dr. Thomas Bodenheimer and nurse Laurie Bauer present the issue in a somewhat different light. Here’s a look at the stats they point to:
About 8,000 physicians entered the workforce in 2015, a number that is expected to hold steady in coming years. Meanwhile, the number of physicians retiring each year is projected to hit 8,500 in 2020. So, the number of MDs retiring will exceed the number of those entering practice.
The number of nurse practitioners entering practice has ballooned from 6,600 in 2003 to 18,000 in 2014. More specifically, the number of primary care NPs is projected to increase by 84% from 2010 to 2025.
If these trends hold, the proportion of primary care providers who are physicians will drop from 71% in 2010 to 60% in 2025 and will continue to decline. The proportion of medical providers who are NPs will increase from 19% to 29% during those years and will continue to rise.
It’s interesting to think about the prevalence of nurse practitioners in the workforce and consider what changes will accompany the trend. While we certainly face a primary care shortage in our country and the broken healthcare system is in need of repair, NPs and PAs can help fill this gap. In the NEJM, Bodenheimer and States propose that even with nurse practitioners, there’s still room for improvement. Who do they suggest will play an integral role in primary care in coming years? RNs.
As nurse practitioners fill in the gaps left by a physician shortage, nurses will begin to take on increasingly complex roles as well. Helping patients comply with medication regimens, make behavior changes to combat chronic disease, and leading care management teams for patients with multiple diagnoses are just some of the roles we can expect nurses to take on in increasing numbers.
How have you seen the way healthcare delivery change in your workplace?