Nurse Practitioners and Physician Assistants

Info about NP at American college of nurse practitioners ( www.acnpweb.org )

and American academy of nurse practitioners ( www.aanp.org ) and for NP education information National Organization of Nurse Practitioner faculties ( www.nonpf.org )

Trumping Professional Roles: Collaboration of Nurse
Practitioners and Physicians for a Better U.S. Health Care
System http://www.graham-center.org/x164.xml

Uncoordinated Growth of the Primary Care Workforce http://www.graham-center.org/x163.xml

Physician Assistants in 1996 were 25% in rural locations and this has declined to 17%. The 40% working with FPGP docs has decreased to 28.5% by 2005. according to AAPA annual surveys http://www.aapa.org/research/index.html

Primary Care Retention - only generalist pediatrics at 70% and family medicine at 92% remain in primary care above 40% of active graduates. Internal medicine residency graduates, medicine pediatrics graduates, nurse practitioners, and physician assistants have declined.

One concern of may American health planners in 1984 is how to utilize some of the extenders who have been produced in great numbers, and how to phase back their educational programs now that an adequate supply of physicians is at hand. Bruce and Norton, Improving Rural Health: initiatives of an academic medical center, Rose Publishing Co. Little Rock AR 1984 p 69

Collaboration of NP and Physician

From National Estimates of Physician Assistant Productivity, WWAMI Center for Health Workforce Studies It takes 1000 PA trained and graduated to equal 346 generalist physician equivalents. Loss of PAs to specialties and lower productivity are costly to a nation in need of primary care. PAs saw 61.4 patients on average per week as compared to 74.2 per physician. FP PAs did 87.3 vs 104.2 per FP doc. Best estimate is that a PA is .78 of an FP doc for calculations for shortage areas and otehr uses. 19.8% of PAs were in Non-Metro settings

Summer 1997 - Volume 13, No. 3.

The Attitudes of Rural Minnesota Family Physicians Toward Nurse Practitioners and Physician Assistants Jeanette Bergeson, Richard Cash, James Boulger, PhD, and Dale Bergeron, MA PP. 196-205 ABSTRACT: Increased use of nurse practitioners and physician assistants has been promoted as a possible solution to the shortage of primary care providers in rural locations. If the use of nonphysician providers is to be optimized in these areas, awareness and acceptance of their capabilities by rural family physicians is essential. This study surveyed the attitudes of rural Minnesota family physicians toward the use of physician assistants and nurse practitioners. Forty-six percent of the 600 rural family physicians surveyed responded to the questionnaire. Approximately 90 percent of responding physicians indicated a high degree of confidence in the abilities of nonphysician providers in the areas of preventive and routine care; some concern was expressed about the proficiency of nonphysician providers taking call, covering the emergency room, and doing hospital rounds-activities that involve a broader base of clinical knowledge and diagnostic skills. Other concerns were an increased workload for physicians due to their assumed supervisory roles, an increase in complexity of cases seen by physicians, increased physician liability, job competition between nonphysician providers and physicians, and the lack of educational opportunities and supervisory guidelines for physicians regarding collaborative relationships. Appropriate roles for family physicians, nurse practitioners and physician assistants are not well-defined in the minds of respondents, and it appears future acceptance and practice patterns will depend on how these roles are established and accepted.
http://www.nrharural.org/search/abs/62.html

Physician Workforce Studies