Hospitals use more NPs, PAs amid doc shortage

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With some hospitals struggling to fill a physician void, more institutions are turning to nurse practitioners (NP) and physician assistants (PA) for a solution. In fact, hospital outpatient visits handled by only NPs or PAs jumped 50 percent from 2000-2001 (10 percent) to 2008-2009 (15 percent), according to a new report from the Centers for Disease Control and Prevention (CDC). Meanwhile, the percentage of visits involving a physician and a nonphysician clinician remained at 3 percent.

The CDC found that the use of PAs and NPs was most common in rural locations, small hospitals, and nonteaching hospitals--settings with fewer physicians.

"PAs and NPs are being sucked into hospital systems because you have a doctor shortage," said Dr. Richard Cooper, director of the Center for the Future of the Health Professions at the New York Institute of Technology, in a Medscape Medical News article today.

Hospitals utilized PAs and NPs for primary care services, with most working in general medicine (21 percent) and obstetric or gynecology clinics (19 percent) versus surgical clinics (5 percent), according to the study.

Hospitals looking to combat a physician shortage may find it easier to recruit NPs and PAs as primary care providers, as they already have an employment advantage over physician practices: The hospitals provide a more challenging work environment to entice NPs and PAs, Cooper told Medscape.

A shift toward more PA and NP utilization could be beneficial to the delivery of care. Research earlier this year found that patients are more satisfied with care from nurse practitioners than from doctors and that care delivered by advanced practice nurses is just as safe and effective, if not more so, than that provided by physicians.

To learn more:
- here's the CDC report
- read the Medscape article (reg. req.)

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