Role Of Nurse Practitioners On The Future Supply And Demand For Physicians

Anderson, Amy. “The Impact of the Affordable Care Act on the Health Care Workforce.” The Heritage Foundation. N.p., n.d. Web. 14 July 2015. This paper is a through report on the impact of the ACA on the workers in healthcare, particularly on the ratio of worker to patients. It shows that the act will increase the physician shortage, particularly in already underserved areas and specialties. It will also greatly increase the stress on workers, due to the increase demand from each physician or nurse and the increased amount of regulatory paperwork required. Many healthcare providers are merging into larger business to cut costs; others are running cash-only or annual-fee models. The act attempts to transition to paying physicians for performance

The aim of the ACA is to provide affordable health care to all Americans, but it still leaves some issues unaddressed that will impact the access to health care. Covino (n.d.), “Though the intentions of the legislation are good, the Affordable Care Act does little to improve the actual health care delivery system” (para.1, page 2). According to the American Medical Association, we are facing an increasing Physician shortage. As of 2010 we faced a shortfall of 13,700 physicians, the estimate is that number will increase to 62,900 by 2015, 91,500 by 2020, and 130,600 by 2025 (Krupa, n.d.), with primary care taking the largest impact. Health Care coverage will be of no benefit if there are no doctors to treat the patients. An example of this occurred in 2002 when Thailand’s’ “30 Bhat Scheme” added (CNN n.d.) “14 million people to the country’s health care system, resulting in long waits and subpar service” (Your health is covered, but who is going to treat you?) Several factors contribute to the physician shortage. Many physicians are reaching the age of retirement, the Association of American Medical Colleges estimates nearly 15 million physicians will be eligible for Medicare in the coming years (CNN n.d.). The increasing cost of malpractice insurance also deters many from pursuing a career in medicine, and is forcing some doctors to retire. Also contributing to the physician shortage is a lack of spots in residency programs. “In 2011, more than 7,000 were left

According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.

The new federal health-care law has raised the stakes for hospitals and schools already struggling to train more doctors. Evidence suggests there won’t be enough number of doctors to treat the newly insured millions under the ACA. At current graduation and training rates, America faces a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The greatest demand will be for primary-care physicians. Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more with longer wait times under the new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER

Currently, there is still a large shortage of primary care practitioners in the United States. The margin between available providers and those in need continues to grow. Many people without proper access to care have to delay seeking help for what ails them ("Health Wanted," 2012). Glicken & Miller (2013) state that approximately 16,000 primary care providers would be necessary to meet the existing demand. Rural communities would represent the area of greatest need followed closely by low-income urban areas. The number of underserved individuals is estimated to have reached fifty-seven million. This demand will only increase, as 52,000 primary care providers are expected to be needed by the year 2025 (Glicken & Miller, 2013, p.1883-1889).

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

Primary care access is a growing concern for all Americans and the reason behind this concern is an imbalance between demand for care and capacity to provide care. Demand is growing as the population expands, ages, and faces chronic illnesses and the capacity is shrinking as the ration of primary care clinicians to population drops (Ghorob & Bodenheimer, 2012). A primary goal of the Affordable Care Act (ACA) was to improve access to quality health care for uninsured Americans, largely through public and private insurance expansions (Polsky et al, 2015). At the same time, the architects of the law recognized the need to increase the availability of primary care providers to meet the increased demand for health care (Pg. 538, 2015).

Americans will have insurance coverage. The US has an unequal distribution of the primary care, thus; the rural areas have been left with only few physicians. Many physicians prefer practicing in urban areas because of the lucrative advantage, better technology or demographic preference. Many sources including Green et al, of Anita Phigpen Perry School of nursing confirms that the reason for the shortage of physicians in the rural areas is due to the tendency of people in the rural areas being poorer, sicker and older . This segment of people tends to be uninsured, and physicians are attracted to urban and suburb areas where revenues are. Today with the ACA policies, people in the underserved area have better access to physicians, although the shortage persists. The US Department of Health and Human Services, states that to help strengthen access to the primary care workforce, the Affordable Care Act invests in health work force training, including: a $ 1.5 billion investment in National Health Service Corps Scholarship and loan repayment programs and $ 230 million over five years to primarily train medical residents in community-bases. However, do we have enough experts?

There is expected to be roughly 17 million individuals becoming newly insured through the Medicaid Expansion of the PPACA by 2019 (Carrier, Yee, & Stark, 2011). The expansion of Medicaid will create a major supply and demand issue within the health care services. Simply put, the demand for primary care services will exceed the capacity of the current primary care infrastructure. This will only add to health care spending because the newly insured individuals will not have many options to obtain primary care services and they may be forced to use inappropriate services such

One state, Massachusetts, enacted the legislation guaranteeing universal health coverage, this overwhelmed the state’s primary care physicians by a wave of newly insured patients. This resulted in advanced practice nurses because they

In the wake of the 2016 presidential election, concerns have been raised regarding the Republicans’ desire to repeal the Affordable Care Act, informally referred to as Obamacare. The ACA was originally enacted into law in 2010 and has been annually provisioned to expand its ability to not only improve the nation’s access to health care, but also to reform the health care delivery system. Through the ACA, private and public insurance has become more available and affordable, new health care delivery models have improved quality of care, and several workforce policies have made primary care a more desirable profession for medical students.

The United States (US) health care system is changing dramatically. The Affordable Care Act is a catalyst that is spurring change by the promotion of two drivers: access and primary preventative care. Before the passage of the Affordable Care Act (ACA) in 2010, over 47 million Americans were uninsured thus denying them access to basic health care (U.S. Department of Health and Human Services [HHS], 2012). Increasing access and increasing the availability of primary care services (pre-natal care, preventative care, primary disease prevention, and secondary disease

The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination.

The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.

An issue that concerns me for the state of Mississippi is the lack of primary care physicians and the lack of interest many medical students have in specializing in a primary care field. Our state has one of the lowest primary care physician to population ratios in the country. Mississippians should be more concerned about the future of healthcare in the state. In my county, there are only two primary care doctors and there aren't any in my town. If I want to see a doctor for a walk-in, I have to drive 20 minutes out of my county to the closest doctor. The truth is, a vast majority of our primary care doctors are over 40 years old and retiring fast with no one to fill their shoes. Many medical school students are opting to specialize in certain