The Primary Care Shortage: Causes and Solutions

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A nurse practitioner examines a young child with her mother.Data from the Association of American Medical Colleges (AAMC) suggests that the U.S. could experience a shortage of up to 124,000 physicians by 2034 , dealing a significant blow to primary care access. In addition to having a negative impact on patient care, the primary care shortage will also undoubtedly increase the demand for nurse practitioners (NPs).

The major causes of the primary care shortage are 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. More than two of every five physicians in the U.S . will be 65 or older in the next decade, according to AAMC. 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.

Nursing professionals who pursue can help close the growing primary care gap.

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.

Considering these reductions, the number of RNs, nurse practitioners (NPs), and other primary care providers who are entering the workforce are hardly sufficient 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, further exacerbating the primary care shortage.

The Impact on Patient Care

Experts worldwide have long stated that the primary care shortage can be directly correlated with declines in patient care quality.

  • Adaptive Medical Partners, the physician recruitment company, reports the primary care provider shortage has made it more difficult for patients in many parts of the country to access care. Additionally, the quality of care is decreasing because patients have less time with their physicians. Due to the primary care shortage, some patients are ignoring health issues, thereby running the risk of exacerbating them.
  • Emergency Medicine News
  • During a public health crisis like COVID-19, a shortage 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 virus. This is due to the key role that primary care providers play in testing, identifying, and communicating with high-risk patients about symptoms and preventive measures, and in managing patient care through telemedicine.

Plans for a Remedy

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

Alaska’s SHARP program and the Delaware State Loan Repayment Plan are two examples of programs that reimburse students for their nursing education. These incentive programs were developed to help offset the primary care shortage. 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 more than 355,000 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. Nurse practitioners are equipped with advanced primary care skills, allowing them to help bridge the physician gap. As such, many who are interested in an advanced practice 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 places students in a strong position to serve in primary care roles.

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 9% by 2030, adding nearly 280,000 new RNs to the workforce. Considering the ongoing primary care shortage and need for high-quality care, it’s expected that demand for DNP-educated nurses will remain high.

A Path Toward the Future

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

Take an active role in the future of nursing and play your part in addressing the primary care shortage. Contact Regis College today to get started.

Recommended Reading

Careers with a BSN to Doctor of Nursing Practice

FAQs About the Online BSN to Doctor of Nursing Practice Program

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Adaptive Medical Partners, “How the Doctor Shortage is Affecting Patients”

American Association of Medical Colleges, “AAMC Report Reinforces Mounting Physician Shortage”

American Association of Nurse Practitioners, NP Fact Sheet

American Medical Association, “Doctor Shortages Are Here—And They’ll Get Worse If We Don’t Act Fast”

Emergency Medicine News, “Overworked Nurses Need Relief”

Human Resources for Health, “Physician Workforce in the United States of America: Forecasting Nationwide Shortages”

Official Alaska State Website, SHARP-3: New Health Care Professionals Workforce Enhancement Program

Proactive Healthcare Recruiters, “The Global Nursing Shortage Causative Factors”

Rural Health Information Hub, Delaware State Loan Repayment Program

StatPearls, Nursing Shortage

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Registered Nurses