Growth of advanced practice clinicians will outpace that of physicians, projections predict

Doctors talking
The growth in the number of nurse practitioners and physician assistants is outpacing that of physicians. (Getty/wmiami)

Nurse practitioners and physician assistants have made up a greater proportion of the healthcare workforce over the last 15 years, a trend that isn’t about to change, according to new projections.

The number of NPs and PAs has outpaced that of physicians, so that roughly two-thirds (67.3%) of practitioners added to the workforce between 2016 and 2030 will be advanced practice clinicians, according to projections in NEJM Catalyst by authors David I. Auerbach, Ph.D., Douglas O. Staiger, Ph.D., and Peter I. Buerhaus, Ph.D., R.N.

The combined number of NPs and PAs per 100 physicians—a figure that nearly doubled between 2001 and 2016—will nearly double again to 53.9 by 2030, according to the projections. Those workplace shifts will probably be even greater in primary care, where the number of physicians has been growing more slowly and where more NPs are working, the authors said.

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But it’s not just primary care practices that are relying on advanced practice clinicians to care for patients, as a study released earlier this year found that 28% of all specialty practices are employing nurse practitioners and physician assistants.

The report said the number of full-time-equivalent physicians is expected to grow by slightly more than 1% each year. That compares to a growth rate in NPs of 6.8% and a growth rate in PAs by 4.3% annually. The Association of American Medical Colleges has predicted a shortage of up to 120,000 physicians by 2030.

So, what will the workforce look like in 2030 according to the projections? There will be an estimated 1,076,360 physicians (up from 716,357 in 2001), 396,546 NPs (up from just 64,800 in 2001) and 183,991 PAs (up from just 44,282 in 2001). The number of NPs and PAs is growing rapidly, in part because of shorter training times when compared with physicians and fewer institutional constraints on expanding the capacity to educate them, the authors said.

Particularly for primary care providers, the shift has meant working in teams of professionals with varying backgrounds and types of training, the report said. “The shifting composition of the healthcare workforce will present both challenges and opportunities for medical practices as they redesign care pathways to accommodate new payment methods, new incentives regarding quality of care and the demands of an aging population,” the authors said.

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