For timely access to care, patients may seek a new path
Fatimah Waseem, USA TODAY
Although about half of U.S. consumers prefer physicians for primary health care, patients are willing to be treated by physician assistants and nurse practitioners to secure timely access to care, says a study by the Association of American Medical Colleges.
About 60 percent of study respondents preferred seeing a physician assistant or nurse practitioner to address a worsening cough if they could be seen the same day. Twenty-five percent preferred an extra day's wait to see a physician, according to the study published in the June edition of the journal Health Affairs.
The findings suggest physician assistants and nurse practitioners may help address the growing gap between the limited supply of physicians and the growing demand for primary care. The nation's physician shortage is expected to reach 90,000 by 2020, according to the Association of American Medical Colleges.
Baby Boomers are growing older, straining medical care. The number of Americans over 65 — the segment of the population most in need of health care — is expected to double by 2060, according to 2012 statistics by the Census Bureau. President Obama's Affordable Care Act will increase demand for primary care providers by requiring millions of uninsured Americans to obtain health insurance beginning Jan. 1.
The study contradicts a 2012 survey by the American Medical Association that found patients overwhelmingly sought a coordinated approach to health care, in which a physician led the team.
In that survey, three out of four patients said they prefer to be treated by a physician even if it takes longer to get an appointment and it costs more.
"Health care professionals have long worked together to meet patient needs for a reason: A physician-led team approach to care works, and patients agree," said AMA President-elect Ardis D. Hoven.
Only 8% of patients use nurse practitioners or physician assistants as primary care providers, suggesting timeliness of care may be the main push factor for patient preferences, according to Deloitte's 2012 U.S. Survey of Health Care Consumers.
"There is no single solution to our problem," said Darrell G. Kirch, president and CEO of the Association of American Medical Colleges. "We need to focus on building our capacity to train physicians while also embracing the roles in which other professionals can serve."
Though patients may not be flocking to alternate forms of care, more physician assistants and nurse practitioners are working with physicians, according to a study in the May-June issue of the Journal of the American Board of Family Medicine.
About 60 oercent of family physicians collaborate with physician assistants and nurse practitioners to care for patients, suggesting this team-based approach may "help alleviate patient access to health care issues," study authors wrote.
Nurse practitioners can treat patients without physician involvement in 18 states and the District of Columbia, a number that could grow as states consider proposals for expansion, according to Health Affairs.
These alternate forms of care may not be enough to address the shortage of doctors, according to a 2012 survey by Staff Care, a national physician staffing company. The survey says staffing requests for nurse practitioners and physician assistants increased from 2% in 2010 to 10% in 2012.
"There are not enough PAs (physician assistants) and NPs (nurse practitioners) to make up for the provider shortages in primary care and other areas," Sean Ebner, Staff Care president, wrote in a statement. "Today, both advanced practitioners, such as PAs and NPs, and physicians are in short supply."
The U.S. Department of Labor expects physician assistant jobs to increase 30% by 2020. Jobs for physicians and surgeons have a similar but slightly lower job growth rate – 24% by 2020.