Special Topics Review – Your Nurse Practitioner Will See You Now
April 2023
Background: Traditional Model
Primary care is traditionally delivered via a physician-led approach. The primary care physician coordinates care with
nurse practitioners, other physicians, and support staff throughout the patient’s life. However, the traditional care
delivery model is being disrupted by more and more primary care nurse practitioners seeing their patients and
developing their own practices. There are two main factors causing a drive towards the advanced practice provider
being the terminus of care instead of the physician: 1) A deficit of primary care physicians, and 2) An aging
population.
The Deficit of Primary Care Physicians
America has a primary care physician shortage. The American Association of Medical Colleges (“AAMC”) estimates
a shortage of 17,800 – 48,000 primary care physicians by 2034.
1 The deficit for primary care physicians can largely
be summarized by the following trends2:
➢ Increasing costs of undergraduate and professional schools
➢ Lower salaries/compensation compared to other specialty/surgical counterparts.
➢ Job dissatisfaction/burnout
An Aging Population
By 2034 the United States is expected to increase its population size by 10.6%. Furthermore, there is an expected
42.4% increase in people 65 or older – the exact demographic that requires more coordinated primary care.
Compounding the population challenges is that 2 out of 5 physicians will be 65 or older.[php light=”true”]H30[/php]
These challenges have created a new avenue for the Advanced Practice Provider (“APP”). Increasingly, APPs staff
retail clinics such those found at Walgreens or local urgent care centers. Nurse Practitioners have autonomy in
almost all aspects of their practice from prescriptions to scheduling. Some states do not even require physician
supervision of the APP.4
As patients look for quicker, on-demand access to primary care, APPs will continue to expand their roles and establish
community access. The demand for nurse practitioners isn’t going away either as the Bureau of Labor Statistics
(“BLS”) projects a 10-year (’21 – ’31) growth outlook for nurse practitioners at 40%.5
As the population ages and the physician deficit grows, more and more patients will be seen by APPs for their primary
care visits.
Please contact the Carnahan Group for additional information or a focused analysis of a particular arrangement.
Prepared by John Michael Li.
1 https://www.medicaleconomics.com/view/are-primary-care-physicians-being-replaced-
2 https://www.health.harvard.edu/blog/why-is-it-so-challenging-to-find-a-primary-care-physician-
202209282822#:~:text=Primary%20care%20is%20getting%20hit,PCPs%20were%20up%20to%2079%25.
3 https://www.medicaleconomics.com/view/are-primary-care-physicians-being-replaced-
4 https://online.maryville.edu/nursing-degrees/np/resources/states-granting-np-full-practice-authority/
5 https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
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