Physician Shortage Isn't the Only One Looming
Health system analysts and assorted other parties have been forecasting a primary care physician shortage for quite some time. An article published recently in the Journal of the American College of Surgeons predicts two additional shortfalls that could affect patient access to care: nurse practitioners and physician assistants.
The study, conducted by medical student Michael Sargen, physician assistant Roderick S. Hooker and physician Richard A. Cooper, constructed projections for the supply of physicians, advanced practice nurses and PAs through 2025 (Sargen M, Hooker RS, Cooper RA. Gaps in the supply of physicians, advance practice nurses, and physician assistants. J Am Coll Surg. 2011;212:991-999). They compared these with projections of demands for advanced clinical services, based on federal estimates of future spending and historic relationships between spending and the healthcare labor force.
"If training programs for APNs and PAs grow as currently projected but physician residency programs are not further expanded, the aggregate per capita supply of advanced clinicians will remain close to its current level, which will be 20% less than the demand in 2025," the authors wrote. "Increasing the numbers of entry-level residents by 500 annually will narrow the gap, but it will remain greater than 15%."
The article states that NP and PA education programs are projected to grow 3% to 5% annually, while no plan exists to expand physician residency programs. An article in American Medical News quotes lead author Sargen predicting that "It will not be possible for physician assistants and advance practice nurses to fill the void, even with the increases in supply that we have projected." Added Cooper: "There is this idea that you can sprinkle a little fairy dust and get more nurses and PAs, but there is in fact a limit to how fast you can expand."
The American Association of Colleges of Nursing has been monitoring the anticipated shortage in many ways. A fact sheet on the association's website lists several reports and studies of APN and RN shortages. Lack of faculty is a primary reason for these. For example, nursing schools turned away more than 67,000 qualified applicants to BSN and MSN programs in last year due to insufficient faculty, clinical sites, classroom space, clinical preceptors and budget.
Physician assistant faculty also are keenly aware of the need to produce more PAs. A shortage of clinical rotation sites is an ongoing challenge, and, like nursing programs, PA programs also need more faculty.
NP and PA faculty and program directors, what strategies are you working on to avert or minimize a shortage of these important providers? Do you think you have the "fairy dust" that is needed?