COMMENTARY

Face-Off: How Nurse Practitioners and Physicians View the Primary Care Shortage

Tom G. Bartol, NP

Disclosures

March 18, 2015

Primary Care Workforce Shortages and Career Recommendations From Practicing Clinicians

DesRoches CM, Buerhaus P, Dittus RS, Donelan K
Acad Med. 2015;90:1-7

The Impending Shortfall of Primary Care Providers

With the passage of the Affordable Care Act (ACA) will be a projected shortfall of primary care providers of about 20,400. Who will fill this void? Will it primarily be physicians, nurse practitioners (NPs), or both? There is a push to increase the training of both NPs and physicians to fill this shortfall, but creating positions to train more primary care providers will not be successful if there are not enough people to fill them.

This article shares the results of a mailed survey of primary care physicians (PCPs) and primary care NPs (PCNPs). It delves into job and career satisfaction as well as how likely PCPs and PCNPs are to recommend their careers to others.

Almost 1000 clinicians (half PCPs and half PCNPs) returned surveys. When asked whether they believed that there was a national shortage of primary care providers, PCPs were less likely than PCNPs to agree that there is a national shortage of primary care providers (52% of PCPs vs 78% of PCNPs). In answer to the question, "Given what you know about the state of healthcare, would you advise a qualified high school or college student to pursue a career as a PCP or PCNP?" 56% of PCPs and 88% of PCNPs would do so. Of interest, even more PCPs (66%) recommended a career as a PCNP.

Current job satisfaction was high among both groups (88% for PCNPs and 83% for PCPs). Career satisfaction (defined as satisfaction beyond the current job) was lower than current job satisfaction but was much higher among PCNPs (73%), whereas only 46% of PCPs reported that they were very satisfied with their careers.

Participants were asked about their level of influence on decisions made in the workplace. In response, 54% of PCPs perceived opportunities to influence their organizations or workplaces, whereas PCNPs expressed less influence. Only 29% of PCNPs acknowledged these opportunities.

The impact of an increasing supply of PCNPs was also evaluated. Slightly more than half of PCPs (57%) believed that their income would decline should more PCNPs enter the workforce, whereas only 22% of PCNPs believed the same. In a similar vein, 74% of PCPs believed that an increase of PCNPs in the workforce would lead to replacement of PCPs by PCNPs. Only 50% of PCNPs believed this to be true.

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