Utilization of Nurse Practitioners to Alleviate the Primary Care Physician Shortage

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What is the Issue? A strong primary care foundation is fundamental to constructing an effective health care system. Patients who have regular access to a primary care physician are more likely than those who do not to receive the necessary preventative care before their conditions become too difficult or expensive to treat (Bindman, Grumbach, Osmond, Vranizan & Stewart, 1996). Additionally, primary care physicians are significant to providing better care to low-income patients. Access to primary care correlates positively with better management of chronic conditions and reduced mortality (Starfield, Shi & Macinko, 2005). Despite the necessity of primary care in regards to health system performance, there has been little value and investment in primary care for decades (McGlynn et al., 2003). Consequently, health care in the U.S. is left poorly coordinated and expensive. The main shortcomings of health care in the U.S. include limited access and difficulty in coordination of care. In an 11-country survey conducted by the Commonwealth Fund, Americans were found to have a greater wait period than adults from other countries. In fact, 20% of adults reported a delay of six or more days to see a doctor or nurse (Schoen, Osborn, Squires, Doty, Pierson & Applebaum, 2010). Access to care is further complicated as only 29% of U.S. primary care practices make arrangements for patients to receive care on evenings, weekends, and holidays (Abrams, Nuzum, Mika & Lawlor, 2011). Physicians also face frustrations in the coordination of care. U.S. physicians are more likely to report that patients cannot afford treatment and are less likely to have electronic patient records that facilitate patient-centered care (Osborn, Schoen, Doty, ... ... middle of paper ... ...34. Seale, C., Anderson, E., & Kinnersley, P. (2005). Comparison of GP and nurse practitioner consultations: an observational study. British Journal of General Practice, 55(521), 938-943. Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of Primary Care to Health Systems and Health. Milbank Quarterly, 83(3), 457-502. Retrieved from http://www.commonwealthfund.org/usr_doc/starfield_milbank.pdf Vaughn, B. T., DeVrieze, S. R., Reed, S. D., & Schulman, K. A. (2010). Can We Close The Income And Wealth Gap Between Specialists And Primary Care Physicians? Health Affairs, 29(5), 933-940. Retrieved from http://content.healthaffairs.org/content/29/5/933.full Yee, T., Bokus, E., Cross, D., & Samuel, D. (2013). Primary care workforce shortages: nurse practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform, 13, 1-7.

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