pa/np is not the answer to primary care shortage

[Guest JMPA]

another lovely article, where is our support, where is our backing?

http://www.medscape.com/viewarticle/809586

[bubbles35]

can you post the article title and author?

[rev ronin]

The article is not attacking our competence, just pointing out that we, like MDs and DOs, tend to go where the money is, which would be specialty practice.

[nhpilot]

I agree...nothing derogatory at all in that article. In fact it addresses the need for MORE primary care PAs..."Relying on NPs and PAs to solve the problem of a growing shortage of primary care physicians may not be an option, and policy makers should not abandon policy solutions designed to increase the number of primary care physicians, NPs, and PAs," the authors write.

[gleannfia]

The snarky comments from all of the "DRs" was disheartening. I have noticed that it is the most insecure and arrogant docs who seem to be threatened by us, not the well-established ones. Anyway, one big factor in why PAs//NPS are going more to specialties is that we require a supervising MD/DO, and they are not always available. Changes to state practice laws should alleviate this. Still 50% of midlevels DO go into primary care, as opposed to less than 10% of MD/DOs.

[wilso2ar]

A guy in the comment section makes a good point. If 1/2 are not in primary care then 1/2 are. So for every 2 PAs produced 1 is in primary care( or .4 if you look at the actual percentage). Compare that to MD/DO.

[physasst]

A guy in the comment section makes a good point. If 1/2 are not in primary care then 1/2 are. So for every 2 PAs produced 1 is in primary care( or .4 if you look at the actual percentage). Compare that to MD/DO.

 

It's not .4

 

The actual number is 33-34% and falling. NPs aren't much better at between 35-37% depending on which data source you use, and MDs are around 31%.

 

The problem isn't where we are, it's where we are going. We went from 68% to 37% by 2007. More recent estimates are 33-34%.

 

http://journals.lww.com/jaapa/Fulltext/2012/07000/A_descriptive_analysis_of_factors_influencing.12.aspx

[Joelseff]

The snarky comments from all of the "DRs" was disheartening. I have noticed that it is the most insecure and arrogant docs who seem to be threatened by us, not the well-established ones. Anyway, one big factor in why PAs//NPS are going more to specialties is that we require a supervising MD/DO, and they are not always available. Changes to state practice laws should alleviate this. Still 50% of midlevels DO go into primary care, as opposed to less than 10% of MD/DOs.

 

This is THE biggest problem. It took me 3 practices to get to FP...and I had to take a pay cut....

[gleannfia]

This is THE biggest problem. It took me 3 practices to get to FP...and I had to take a pay cut....

That is a shame! The problem is, with fewer docs going into FP and even then not wanting to work in remote or less desirable areas, who are we going to have to supervise us? We need to mobilize state-by-state for practice law change. Problem is we don't have the numbers to fight like NPs do.

[Joelseff]

That is a shame! The problem is, with fewer docs going into FP and even then not wanting to work in remote or less desirable areas, who are we going to have to supervise us? We need to mobilize state-by-state for practice law change. Problem is we don't have the numbers to fight like NPs do.

 

I agree but that will be met with lots of push back and truthfully, PAs are not quite strong enough, IMO, to do that. One practical way that might meet less push back is to expand the number of PAs that a doc can supervise from 4 to, I dunno, 10 LOL. Maybe not ten, but you get my drift.

 

My SP and I were talking about this a few days ago. We are also HIV specialists along with FP, and he serves as a medical director for a non-profit HIV clinic. He has 2 PAs there and me here at his private office. The clinic wants to expand to Full FP care for and underserved community and they are thinking of picking up more PAs. BUT...Since he is the only MD on staff, they can only pick up one more. They are actually looking into NPs now...He prefers PAs due to our medical training but the legislation really chokes the Docs and facilities. In turn affecting our marketability.

[Guest JMPA]

can you post the article title and author?

 

Medscape Medical News

[h=1]Primary Care Shortage: NPs and PAs May Not Be the Answer[/h]Troy Brown

Aug 16, 2013

[MedicinePower]

I posted a comment in that article which says

 

I strongly disagree with this article. While it is true that PAs and NPs work in specialties they are far, far more likely to go into primary care. In fact several PA and NP programs are specifically geared for primary care. Touro University's PA Program focuses entirely on educating a primary care PA, while an NP must choose a specialty such as "Family Nurse Practitioner" (aka primary care). Moreover, the number of graduates from PA and NP school is increasing rapidly. Ten years ago there were only 70 PA schools, now there are over 170 PA schools. The same growth is happening in NP programs. To say that PAs and NPs will not play a significant (even majority) role in primary care is to deny the rising of the sun in the east.

[physasst]

I posted a comment in that article which says

 

No they aren't. Any credible source of data, including PAs (see the most recent one by Coplan and Cawley)

 

http://www.annfammed.org/content/11/1/75.full

 

Although the absolute number of PAs working in primary care has increased overall, the percentage of PAs in primary care has declined from 50.8% in 1996 to 31% in 2010.⁴ This trend correlates with a similar trend among physicians.^3,5

[MedicinePower]

Interesting study.

[CAdamsPAC]

What's pretty funny to me is, a pop up ad boasting that patients using the subject Urgent Care Center will be seen by physicians was at the top of this thread!!