Some members of the health care industry have been concerned that an influx of newly-insured Americans under Obamacare will exacerbate an existing primary care doctor shortage and strain physician’s resources as more people seek basic treatment. But a new study by the RAND Corporation finds that this dreaded shortfall could be cut dramatically by giving nurse practitioners and physician assistants more authority to provide basic care — something that Obamacare already encourages.
Physician groups estimate that the primary care physician shortage could reach 45,000 by 2025. But with the help of “medical homes” — collaborative models where doctors, nurse practitioners, pharmacists, physician assistants, and other health professionals work together to provide patient care — and nurse-managed health centers, that number could be cut in half or even more, according to the researchers. Obamacare provides about $50 million in funding to promote such collaborative programs.
“Growing use of new models of care that depend more on nonphysicians as primary care providers could do much to reduce the nation’s looming physician shortage,” said lead study author David Auerbach. “But achieving this goal may require changes in policy, such as laws to expand the scope of practice for nurse practitioners and physician assistants, and changes in acceptance, on the part of providers and patients, of new models of care.”
Still, states — which regulate the scope of services that can be provided by nonphysician health care workers like nurse practitioners and physician assistants — would have to take legislative action to make these new models feasible. Some have already begun the process. For instance, in June, Nevada Gov. Brian Sandoval (R) signed a bill allowing nurse practitioners and physician assistants to prescribe medications without having to first get permission from a doctor. That can be especially useful for patients who don’t have many physicians in their area and lack the time or means to make a trek out to the hospital.
Some doctor groups have been skeptical about giving non-doctors more authority. But their concerns are likely overblown, since nurse practitioners (who have more extensive training than regular nurses) and physician assistants have been shown to provide the same quality of certain basic primary care services as full-fledged doctors.