The Primary Care Provider Shortage and Strategies to Help

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Nurse visit sick child at home to check her heart rate.

Data from the Association of American Medical Colleges (AAMC) suggests that the U.S. could see a shortage of up to 121,900 physicians by 2032. In addition to having a negative impact on patient care, the primary care provider (PCP) shortage will also undoubtedly increase the demand for nurse practitioners (NPs).

The primary care provider shortage is largely rooted in the following key areas: First, the number of graduating physicians who choose the primary care provider path is declining. Second, the number of primary care providers who are entering retirement continues to grow. The AAMC estimates that by 2025, roughly a third of practicing primary care providers will be age 65 or older. Additionally, public health crises like the COVID-19 pandemic, which spike the demand for primary care, put an additional strain on primary care doctors and make the challenge of meeting patients’ needs all the more daunting.

A Brief History of the Health Care Provider Shortage in the U.S.

U.S. health care staffing shortages aren’t unique to primary care physicians. While lower starting salaries have contributed to fewer primary care providers in the profession, the number of working registered nurses (RNs) has also been declining for almost three decades.

The U.S. nursing shortage began in the early 1990s, when health insurance providers initiated cost-cutting policies. Licensed, experienced nurses were replaced with less skilled aides, and the layoffs made the profession unattractive to those who had other career prospects.

Given these reductions, the number of nurses, nurse practitioners, and other primary care providers who are entering the workforce is hardly enough to keep up with the needs of the aging population. To complicate matters, COVID-19 has devastated many primary care practices which rely on in-person visits to stay open. There seems to be no easy solution. During pandemics, providers must discourage patients from coming into their offices to prevent transmission. As a result, many primary care providers may be forced to close.

The Impact on Patient Care

Experts worldwide have long stated that insufficient primary care provider and nursing staffing levels can be directly correlated with declines in patient care quality.

● CBS News reported that the primary care provider shortage has made it harder for patients in many parts of the country to access care. Data from MarketWatch supports this finding and indicates that in some states, such as Connecticut, only 15 percent of primary care needs are being met.

● A 2018 report published in the American Journal of Nursing found that when a nurse’s workload exceeds an optimal level, the likelihood of patient mortality safety incidents increases between 8% and 34%, and the likelihood of mortality increases 43%. Researchers also found that the odds of patient safety incidents or death decreased by 25% when workloads were lowered.

● During a public health crisis like COVID-19, an insufficient number of primary care providers can lead to less quantity and quality of care. The shortage can also stifle overall efforts to control the outbreak of the disease. This is due to the key role that primary care providers play in testing, identifying and communicating with high-risk patients about symptoms and preventative measures, and in managing patient care through telemedicine.

Plans for a Remedy

Many states have begun to implement strategies aimed at reversing the U.S. health care provider shortage. Programs that are geared toward increasing student enrollment in nurse practitioner (NP) programs, including those that provide future nurses with fellowships and student loan forgiveness, are already underway.

Alaska’s SHARP program, for example, offers up to $47,000 in student loan forgiveness to nurses, while the Delaware State Loan Repayment Plan offers up to $30,000. Those interested in pursuing a nursing career may be interested to learn that state, federal, and military loan forgiveness and repayment programs are available nationwide. Additionally, in the wake of COVID-19, lawmakers have proposed plans to forgive loans for nurses and others who are considered essential workers.

The Changing Landscape of Health Care

Despite the current RN shortage, 2020 data from the American Association of Nurse Practitioners (AANP) reports there are 290,000 licensed nurse practitioners (LNPs) in the U.S. This is a marked increase from 2007, when the nationwide total hovered around 120,000.

The rise in popularity of this career path doesn’t appear to be directly linked to the RN shortage, but it can be linked to the primary care physician shortage. A 2019 Advisory Board study found that effectively using LNPs could have the same impact as adding 44,000 primary care physicians to the workforce. As such, many who are interested in a nursing career are opting to pursue a Doctor of Nursing Practice (DNP). In addition to providing the education and background to be successful NPs, this degree program well positions students to serve as primary care providers.

DNP nurse educators are also playing an important role in helping prepare tomorrow’s nurses. The U.S. Bureau of Labor Statistics (BLS) forecasts that RN employment will grow by 12% by 2028, a rate more than double the average job growth for all other occupations. Consequently, the need for DNP-educated nurses will remain high.

A Path Toward the Future

The online BSN to Doctor of Nursing Program at Regis College is specifically designed to provide students with the tools to be successful in their careers. Credentialed nurses who are interested in teaching and having greater autonomy, better career options, and greater earning potential will find the program to be a unique and powerful experience.

Take an active role in the future of nursing. Contact Regis College today to get started.

Recommended Reading
What Is a Doctor of Nursing Practice? Examining an Advanced Degree
What Is a Nurse Mentor?
Nurse Safety and Prescribing Medications: A Delicate Balance

Sources
Alaska Department of Health and Social Services, SHARP Support-for-Service
American Association of Nurse Practitioners, NP Fact Sheet
American Journal of Nursing, “Higher Than Optimal Nurse Workloads Increase the Odds of Patient Mortality”
Association of American Medical Colleges, New Research Shows Increasing Physician Shortages in Both Primary and Specialty Care
BMJ Quality & Safety, “An Observational Study of Nurse Staffing Ratios and Hospital Readmission Among Children Admitted for Common Conditions”
CBS News, Shortage of Primary Care Physicians Could Threaten Patient Care
Forbes, “There Are Now Five Plans To Forgive Student Loans — How Do They Compare?”
Harvard Business Review, “The Problem with U.S. Health Care Isn’t a Shortage of Doctors”
MarketWatch, “America’s Facing a Shortage of Primary-Care Doctors”
PatientEngagementHIT.com, “NPs, Pas Could Reduce Primary Care Physician Shortage Nearly 70%”
Proactive Healthcare Recruiters, The Global Nursing Shortage Causative FactorsResearchGate, “A Historical Perspective on the Nursing Shortage”
The Atlanta Journal-Constitution, “The Great Nursing Shortage: Which States Are Hit Hardest and What’s Being Done to Help?”
STAT, “Primary Care Is Being Devastated by Covid-19. It Must Be Saved”
U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
U.S. Bureau of Labor Statistics, Registered Nurses
U.S. National Library of Medicine, “Nursing Shortage
U.S. News & World Report, “What Nurses Need to Know About Student Loan Forgiveness” WBUR, “Nursing a Shortage