The appropriate scope of practice of nonphysician providers is a hotly debated issue. But what’s not debatable is that these individuals will play a crucial role in helping practices serve their patients amid the growing primary-care physician shortage.
Unfortunately, their ability to do so may be limited — and I’m not just referring to regulatory and scope of practice barriers. As is the case with physicians, there may be a looming shortage of NPs and PAs in the coming years.
According to a new survey from temporary healthcare staffing firm Staff Care, the number of PA and NP temporary staffing requests increased from accounting for just 2 percent of all requests in 2010, to accounting for 10 percent in 2012.
So what does that have to do with a possible NP/PA shortage? Practices and other health systems tend to look for temporary providers when they are having trouble finding permanent employees, according to Staff Care. “There are not enough PAs and NPs to make up for provider shortages in primary care and other areas,” Sean Ebner, president of Staff Care, said in a statement. “Today, both advanced practitioners, such as PAs and NPs, and physicians are in short supply.”
To determine what the staffing supply of NPs and PAs currently looks like and how it will look in the future, we asked the American Academy of Physician Assistants (AAPA) and the American Association of Nurse Practitioners (AANP) to weigh in.
James Delaney, AAPA president and a practicing physician assistant, told Physicians Practice that more than 95 percent of physician assistants who want to be employed are currently employed. This suggests, of course, that PA supply has nearly reached capacity. Delaney added that he anticipates demand for PAs will continue picking up steam. “There appears to be an insatiable appetite to the employment of PAs within the medical community right now and certainly no end to that in the near future that we see,” he said.
While the number of PAs that enter the workforce grows each year, Delaney said it’s difficult to predict whether the increasing number of new PA graduates will be enough to meet the growing demand for their services. “I don’t think anybody really knows that answer,” he said.
Mary Jo Goolsby, AANP vice president and an adult practitioner, expressed similar concerns regarding the supply of nurse practitioners. While the number of practicing NPs is growing, there may not be enough to fill the growing need for individuals who can provide primary-care services in the coming years, she told Physicians Practice via e-mail. “We believe more are needed since they focus primarily on primary care, where huge need is well-established.”
Delaney did, however, express some cautious optimism regarding PA continued growth in the coming years. As many states rethink PA scope of practice regulations, the opportunity is there for PAs to more thoroughly fill the need for primary-care services, he said.
In addition, while there are currently 170 PA training programs nationally, an additional 60 to 65 are in the pipeline. “We graduate about 7,000 PAs a year right now, and it’s predicted that in the next 10 years that number will grow to over 10,000 to 12,000 graduates per year with the addition of these programs,” said Delaney. “We’re doubling our numbers roughly every 10 years right now.”
Do you think your practice will look to hire a physician assistant or nurse practitioner in the coming years? Why or why not?