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How Teamwork Can Save Primary Care

By Alexandra Wilson Pecci  
   August 27, 2013

A shift away from fee-for-service and toward a population management model of healthcare wouldn't involve nurse practitioners and physician assistants replacing doctors; it would call on all providers to work together as a team.

Just like physicians, nurse practitioners and physician assistants are increasingly choosing to specialize, rather than to practice primary care, says a research "one-pager" from the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.

On the surface, this little nugget of information might seem a bit unremarkable. After all, primary care salaries generally fall short of those in specialty fields, and practitioners face heavy financial burdens, such as education debts.

But there are more wide-ranging implications of this PA/NP subspecialty trend, and they are neatly summarized by the one-pager's title: "Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care."

Other data has suggested that a majority of NPs graduate with primary care degrees, but those numbers don't accurately reflect where NPs actually practice a few years after graduation. (Check out another instance of measuring specialties too soon after graduation here).

Using data from the National Provider Identifier, (and assuming that NPs and PAs who practiced without a physician or co-located with a primary care physician were providing primary care), the Graham Center researchers concluded that fewer than half of PAs and slightly more than half of NPs practice in primary care.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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