It is widely accepted among the medical community that nurse practitioners and pysician assistants can do about 80-85% of the job of primary care physicians. With the affordable care act emphasizing coordination of care among all kinds of medical providers and the recognition of nurse practitioner and physician assistant abilities, it seems primary care doctors may no longer be necessary.
I was surprised to read an article authored by a physician last month on popular physician blog Kevin MD titled ‘Primary care doctors may no longer be needed’. Kevin MD trends toward physician based medicine and at times holds an antagonistic view of nurse practitioners. Dr. Doug Olson, author of this article, admits that NP’s and PA’s can perform the majority of primary care services, and at a lower cost than physicians.
Nurse practitioners train for fewer years than physicians, have lower costs of education and are reimbursed at lower rates than physicians making them a cost effective alternative to the primary care doctor. With the political changes surrounding primary care, fewer and fewer medical students are electing to become family physicians. Dr. Olson believes these factors will result in major changes within the primary care system weeding out the traditional primary care physician.
Like Dr. Olson, I predict a dramatic decrease in the number of primary care physicians in the near future with these doctors being replaced by nurse practitioners and physician assistants. Nurse practitioners are extremely capable, especially in the primary care realm. With proper referral systems and protocols in place for treating the 15-20% of primary care patients falling outside of an NP’s abilities, nurse practitioners and physician assistants will become the new face of primary care.
A larger nurse practitioner presence in primary care will improve medicine for both patients and providers. Increasing NP and PA presence in family medicine will cut the cost of medical care for patients increasing access to primary care services and patient satisfaction. Allowing physicians to focus on treating mainly the sickest, most complex patients will put their higher level medical training to greater use increasing job satisfaction at a time when many doctors are expressing frustration with their careers.
A nurse practitioner and physician assistant based primary care model is on the horizon for our country. This is good news for the nurse practitioner profession.
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