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As the number of primary care doctors lessens, capable nurse practitioners and physician assistants are stepping forward to plug the patient care gaps, increasing the number of hands on deck to form an active team of providers.
Of course, the role of physicians and the mid-level providers that function under their supervision are not interchangeable, this distinction rooted in a difference in education. Nevertheless, patient care appears to have much to gain from this heightened system of collaboration. Read on to discover more about this rising trend in healthcare:
On any given day at Valley Medical Group’s Northampton Health Center, Christine Normandin sees up to 22 patients. She diagnoses and treats their ailments and advises them on improving their health. And sometimes, she corrects them when they call her “doctor.”
“I have to say, ‘I’m not a doctor, I’m a nurse practitioner,’” Normandin said in an interview at the health center on Main Street in Florence. Most patients are familiar with nurse practitioners and physician assistants, Normandin said, and they seem comfortable with the idea that they are the ones likely to be treating them.
Patients from western Massachusetts and across the country can expect to see more and more nurse practitioners and physician assistants in their exam rooms, according to experts in the healthcare field. This is because a trend toward using more of these professionals—sometimes called mid-level providers or advanced practitioners—is expected to continue, driven mainly by a shortage of primary care doctors.
The article goes on to describe the care that nurse practitioners and physician assistants are prepared to offer:
Nurse practitioners and physician assistants are medical providers who are educated through master’s degree programs and hours of clinical experience—though they still spend less time and money on schooling than doctors. Required to practice under the supervision of a physician, they work with varying levels of autonomy in hospitals, medical centers or, in some states, even their own private practice. “They provide basic healthcare and handle complicated cases, too. Some people prefer them because they can generally have a little more time with them than with doctors,” Feinman said. “They have a broad scope of practice. They can order tests and procedures and write prescriptions.”
Nationally, Feinman said, there has been a big need for primary care physicians, even before the Affordable Care Act created droves of newly insured patients. “The real problem is we’re not training enough primary care physicians,” he said. “More are training in specialties.” Doctors in specialties from cardiology or ophthalmology can earn more based on the way insurers and Medicare and Medicaid reimburse them, he said.
And here’s a snapshot of just how great that need is:
According to a 2013 Access to Care Study put out by the Massachusetts Medical Society, new patients in Franklin County had the longest wait to get a family practice appointment at 106 days. That’s followed by the three other counties in western Massachusetts: Berkshire County is second at 102 days, Hampden County is third at 58 days, and Hampshire County has the fourth longest wait in the state at 56 days. The state average was 39 days in 2013, the report said. According to the same study, around half of family medicine physicians in western Massachusetts were accepting new patients in 2013.
“That’s basic healthcare. People don’t expect to wait 102 days,” Ahmed said.
Okay, so what’s the difference between a nurse practitioner and a physician’s assistant?
The differences between physician assistants and nurse practitioners is based on the type of training they receive, according to their respective national organizations. While both professions require a bachelor’s and master’s degree before certification, physician assistants attend a program modeled on the medical school curriculum that doctors go through. Nurse practitioners go to nursing school, where their education focuses more on looking at “the whole picture” of a patient’s health, as Normandin put it. Both are required to complete hours of clinical experience before they can be certified.
They may have specialties, but both nurse practitioners and physician assistants train and re-train in general medicine. Seventy-five percent of nurse practitioners work in primary care, according to the American Association of Nurse Practitioners, compared to about one-third of physician assistants.
The end goal, however, is mutual:
“What’s much more important is enabling providers to make the most of their time with patients and make the greatest-possible contributions to their patients’ health,” Muehlberg said in an email. “In other words, allow doctors to spend time doing things that only doctors can do, and advanced practitioners to spend time doing things at which they’re most effective, too.”
Care to read more about the expanding roles of nurse practitioners and physician assistants? Check out the full article here, courtesy of the Daily Hampshire Gazette.
As always, don’t forget to share your thoughts on this fascinating shift in healthcare in the comments section below!