The Leaflet: A Simple Solution to the Primary Care Physician Shortage

Published September 21, 2018

As the population grows and baby boomers increasingly require medical services, Americans are experiencing a shortage of primary care physicians. Unfortunately, the dearth of primary care physicians is being perpetuated by an eruption in health care regulations that are driving doctors out of the health care industry.

In the United States, there are 7,181 Health Professional Shortage Areas, as designated by the federal government. This means about 84 million Americans do not have access to primary care, a majority of whom reside in rural areas. By 2030, Americans could experience a shortage of 120,000 physicians, according to the Association of American Medical Colleges.

Nurse practitioners (NP) are well-trained, well-educated medical professionals that can deliver high-quality primary care to meet Americans’ increasing health care needs. If allowed to practice fully, NPs can evaluate and diagnose patients, order and interpret diagnostic tests, and initiate and manage treatments. Some states reduce NPs ability to practice to the fullest extent. Others go even further and restrict NPs from practicing without supervision, delegation, or team management by another medical provider.

According to a new report from American Enterprise Institute, 22 states and the District of Columbia allow the full practice of NPs, as recommended by the National Academy of Medicine and National Council of State Boards of Nursing. Another 16 states allow for a reduced level of medical practice by NPs. Unfortunately, 12 states severely restrict NPs.

To counter the growing threat of doctor shortages, several states are taking steps to increase access to primary care. For instance, Ohio, Texas, and Virginia are exploring ways to expand nurse practitioners’ scope of responsibilities and permit them to practice without direct doctor supervision.

Ohio legislators are considering a proposal that would allow well-trained NPs to work independently of physicians. Under current statute, NPs in the Buckeye State must complete a Prescriptive Authority Agreement—which can cost hundreds of thousands of dollars—in order to independently provide basic medical services, such as disease diagnosis, treatment, and prescription medication orders. 

Every year, 248,000 NPs across the nation provide one billion patient visits. Because the demand for primary care is expected to increase dramatically, states should pursue measures that incentivize NPs to provide affordable care. Additionally, legislators should reduce regulations on direct primary care, repeal certificate of need laws, and eliminate maintenance of certification. The primary care shortage is not inevitable, unless states continue to stifle the services NPs can provide to millions of Americans who welcome the opportunity to receive affordable, high-quality care from NPs. 


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