In our previous blog post, we talked about the massive physician shortage the U.S. is facing.  Here we take a closer look at why physicians are burned out, what's currently being done to address the issue and how, in the meantime, trusting your nurse practitioner is not a bad thing.

Currently, the main way physicians make money is dependent on how many patients they see — it’s known as fee-for-service medicine.  In the average clinic, you have no choice but to see as many patients as humanly possible because numbers are crucial in fee-for-service reimbursement models.  All the reimbursement received for each patient pays the doctor’s office staff.  If a physician chooses to spend more time with fewer patients, they will see a cut in pay, or worse, be forced to layoff staff.

Primary care faces extra challenges because they are reimbursed less per patient than specialists. In fact, according to the Medical Group Management Association, they make one-third the average income of an orthopedic surgeon or cardiologist.  Because of this, PCP offices are typically unable to hire the staff they need to see more patients and spend time with each one.

Unfortunately, there’s no easy fix to this problem.  There are currently efforts underway that include everything from decreasing residency time to improving telehealth to redoing the reimbursement model altogether and rewarding doctors for the quality of care they provide as opposed to the quantity of patients they see.  Locally, one health plan, Essence Healthcare, operates on a quality-based model, actually reimbursing physicians at higher rates for taking more time with patients and meeting quality metrics.  So far, it’s proven incredibly successful and effective locally, but it’s far from being adopted at a national level. This nation-wide problem will take time to fix. In that time, a RAND Health study predicts the number of NPs will increase by 94 percent in the next ten years as they take on a more prominent role in healthcare.

This may be frustrating for patients who have a strong relationship with their PCP, but NPs and PAs are not a bad substitute.  An NP, for example, has extensive education and medical training.  Typically, they have six to eight years of post-high-school education that involves intensive clinical work.  Similarly, PAs have up to six years of post-high-school education and are required to perform clinical rotations and pass state exams to become licensed.  Both NPs and PAs are well trained and educated to step in for your overworked PCP when needed.  Perhaps most importantly, the PCP you trust, trusts their NPs and PAs.  They are an extension of your physician, and can be counted on to deliver the kind of care your personal physician would provide themselves.

Becoming a physician is not as glamorous as it once was.  In fact, it’s a pretty tough job. NPs and PAs are there to help your physician ensure that all the patients who need care receive it in a timely matter.  And, if your PCP is unable to see you, it’s probably not their fault. In the meantime, if you have to see an NP or PA, know that you are in the safe, educated hands of someone your physician trusts.