Nurse practitioners face barriers to helping areas underserved by PCPs
Nurse practitioners in California are prepared to help fill shortages of primary care physicians in underserved areas around the state—but several barriers challenge this practice, according to a survey published Sept. 4 in Health Affairs.
Regulations that require a supervising physician, as well as the geographic location and practice area of nurse practitioners, limit their ability to fill gaps in primary care. The survey looked at responses from 1,271 nurse practitioners.
The findings come at a time when several states and policymakers are looking for ways to leverage this workforce to meet future primary care needs, with 22 states and the District of Columbia removing barriers that once prohibited NPs from providing care without physician supervision or collaboration.
By 2030, PCP supply is likely to meet less than half the demand in California, according to recent forecasts. At the same time, the nurse practitioner workforce is growing rapidly and could help fill that anticipated gap. Up to 75 percent of PCP care can be conducted by a nurse practitioner.
From 2007 to 2017, the number of nurse practitioners in the state grew from approximately 14,636 to 19,768, the study reported. National trends are similar, with 120,000 nurse practitioners in 2007 and more than 234,00 in 2017.
However, while there is some hope that nurse practitioners can help meet future care demands, California faces several challenges to leverage this workforce, the survey found.
“Although the nurse practitioner workforce is growing in California and can help address looming shortages of primary care physicians, the data presented here provide some cause for concern,” the survey report reads.
While more primary care will be needed in underserved areas, nurse practitioners tend to live in high-density areas of both NPs and physicians, according to the research. However, newly graduated nurse practitioners were more likely to live in counties with lower-than-average ratios of both provider types than other counties, meaning this cohort could play “an important role” in filling primary care gaps.
Another potential issue is the age of the workforce. Even as the job continues to grow, more than 40 percent of nurse practitioners are 55 and older, meaning a huge chunk of the workforce will have to be replaced over the next several years to simply maintain current demand.
“Growth in graduations is essential to ensuring that there will be an adequate supply to fill positions when retirements occur,” the report reads.
Many NPs–40 percent–also tend to work within 40 miles of where they graduated, which means more nursing schools in underserved areas will be necessary to meet future demand. Increasing diversity could also improve the supply in underserved areas, the research found.
Another area of concern is a high rate of nurse practitioners who recently graduated and plan to move to another state. Researchers noted that future research on work environments should be conducted.
“Retention of health professionals is strongly influenced by non-financial factors, including work environments that encourage professional collaboration,” the report reads.
Surprisingly, regulatory barriers in the state still exist, but many nurse practitioners reported that they are able to conduct their work without much impediment by regulations, the survey found.
Still, California policymakers should consider lifting regulatory and other burdens to further leverage this workforce and meet rising demand for primary care, researchers urged.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."