UCLA-led research finds that contrary to physicians’ beliefs, advanced-practice clinicians such as nurse practitioners and physician assistants do not provide more costly and unnecessary tests, treatments and referrals to specialists compared with physicians in the primary care setting.
The article, published June 21 in the peer-reviewed journal Annals of Internal Medicine, is one of the largest national studies to date on this issue and could inform the ongoing debate into expanding the role of advanced-practice clinicians in doctors’ offices and hospitals. They could also dispel the commonly held belief among physicians and physician groups that these clinicians provide more of such needless services, which are known as low-value health services.
Advocates say that expanding the role of advanced practice clinicians could improve access to necessary care for millions of Americans. The United States currently faces a looming shortage of primary care physicians, especially with the Affordable Care Act making health insurance available to millions of people who previously lacked coverage.
While not calling for advanced-practice clinicians to replace physicians, the findings suggest that they could pick up much of the slack in some services that general practitioners provide, particularly for relatively straightforward conditions with clearly defined guidelines such as the ones the researchers studied, said Dr. John Mafi, assistant professor of medicine in the David Geffen School of Medicine at UCLA, and the study’s lead author.
“Some estimate that we’re going to be short 20,000 doctors by 2020 and the causes relate to both supply and demand,” Mafi said. “There’s more demand for primary care providers due to the ACA, so millions of newly insured patients are looking for a provider — yet there are fewer trainees entering primary care because it’s lower paid and harder work.
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