One solution gaining more attention to help address the growing demand for more primary care providers is better use of nurse practitioners and physician assistants. Expanding the role of NPs and PAs in primary care is a cost-effective solution to the looming primary care shortage. In fact, both were created nearly a half century ago to address this very problem. There are currently 125,000 practicing NPs and nearly 74,000 practicing PAs in the United States. The quality and cost-effectiveness of both NPs and PAs is well-documented.
NPs and PAs have been providing quality, cost-effective health care since the 1960s. We can rapidly expand our primary care workforce effectively and efficiently by training more of these clinicians. The timeline for training NPs and PAs is half that of a primary care physician—only six years rather than 12 years post high school. Six years is also the amount of training for European primary care physicians, who begin medical training immediately after secondary school. The majority of the educational expense accrues in medical school and residency training, and it is estimated that training nurse practitioners and physician assistants is 20 to 25 percent of the cost of training a physician. Salaries for NPs and PAs are also less than half the average salary of a primary care physician—the base salary of a NP or PA is just over $82,000.
The primary care shortage requires us to maximize the use of every health care professional to the full extent of their training and competency. As health economist Mark Pauly, professor of health-care management at the Wharton School of Business argues, “making greater use of advanced practice nurses is one way to trim costs and maintain high quality.”
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