Nurse practitioners may fill gap created by Obamacare

A shortage of primary-care physicians may push patients toward other health care professionals who can provide similar services.

By Julie K Balise Aug 2, 2013 3:44PM

Obamacare may improve the healthcare provided to millions of Americans -- if they can get it.


Primary-care physicians are already hard to come by. With the Affordable Care Act, there will be 91,500 fewer physicians than needed in 2020, according to a study from the Association of American Medical Colleges. That shortage shrinks to 65,100 physicians if the Affordable Care Act is not fully implemented.


Bloomberg's Olivia Sterns suggests looking to other health care professionals to meet this need.

"When the Affordable Care Act actually kicks in there are going to be millions more Americans suddenly seeking out this kind of primary care because they finally have insurance," she said in the report. "One potential solution though to plus this gap is to try to transfer some of the load to nurse practitioners."


Two-thirds of nurse practitioners already provide primary care, according to the report. They can write prescriptions, provide physical exams, and serve as the first point-of-call for a sick patients. They can work independently or in a collaborative agreement with a physician.


Sterns met with Susan Apold, a nurse practitioner in New Rochelle, New York, to discuss her experience.


Apold said they nurse practitioners are a cost-effective necessary healthcare provider.


"If Affordable Care is going to work and if we're going to recognize savings we have to look at primary care, preventing the problem, and once a person has the problem, managing the problem," Apold said in the report.


Nurse working at a computer (© Tetra Images/Gett Images)All nurse practitioners have advanced degrees in nursing. Certification and license requirements vary by state. There are currently about 167,000 nurse practitioners in the U.S., according to the report. Sterns said that number is expected to grow to about 250,000 by 2025.


Sterns cited the New England Journal of Medicine's report showing that the cost of training three to 12 nurse practitioners is equal to the price of putting one doctor through medical school.


For every 100,000 Americans, there are 30 primary-care physicians, Sterns said. She compared this to the United Kingdom, Germany, and France, where there are 80, 157, and 159 physicians per 100,000 people, respectively.


A 1996 government study suggested having 60 to80 primary care physicians per 100,000 people, and 85 to 105 specialists per 100,000 people in the early 21st century.


Until that is possible, Sterns said nurse practitioners can help meet the need.


"This really is a hot sector of the job market," she said in the report. "And many are hoping could also be a smart way to bring down costs overall in U.S. healthcare system."


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Aug 3, 2013 9:49AM
Sure, because you will pay hell waiting to see a doctor...
Aug 3, 2013 7:09AM
CRNP's can do many things, but not all. If you have a cough or a cold, need a shot, OK. BUT serious things that require lab work and diagnoses will require a tad more than what they can do. I recently had some tests done that required anesthesia. When I got the bill, I saw 2 identical charges. When I questioned it, I was told one was for the nurse anesthetist and the other was for the supervisor watching her. There you have it. Many times I've had my CRNP stop, head into the PCP's office, and come back minutes later with what needs to be done. They have a place, but can't replace the PCP. 
Aug 3, 2013 11:57AM
Contact the legislative crooks you voted into office and demand they stop funding the Obamacare farce before it is too late!  Tic tock....your money, your health, your life. 
Aug 3, 2013 12:59AM
When it all washes out, this is a moot point, in the end not nearly enough young people are going to sign up to fund this scam. Obamacare will collapse.under its own weight.
Aug 3, 2013 5:07PM
My mom lived to 102+.  She had a Nurse Practioner see her for her last two years because no doctors would make home visits.  When I was a child, ALL doctors made home visits for about $25.  Today's PCP's want to maximize their income, which can't happen when the typical office visit lasts only 10-15 minutes.  That's far less than the one-way travel time to most patients' residences.  It's all about the money now.  In a few years, even the NP's won't make house calls to the elderly and disabled.
Aug 4, 2013 1:49PM
welcome to the 30 hour work week, a fringe benefit of obamanama non-care.
Aug 5, 2013 12:22AM
Already doing that in my town in Oregon, and I am totally satisfied with the service provided. I go in for routine checkups 2 or 3 times per year with the Physicians Assistants handling all the routine checkup; only see the Dr. once in a while. They monitor my meds and update prescription if needed. Dr. is involved only if there is a need for further evaluation. I see little need for significant increases in the number of physicians; just expand and refine this model nationwide.
Aug 3, 2013 11:40AM
This is exactly why Obamacare is a disaster for our healthcare. Nurse/Practicians are about the only thing that will be available for most of us. What's next, a drive- thru heart valve replacement procedure?
Aug 3, 2013 11:21AM
Obamacare isn't the reason nurse practitioners are taking on more medical care responsibility. The system will no longer support medical doctors in general and family practice due to high costs of education and the ability to make more money in other fields base on education. The other problem is simply the insurance  companies need for large profits for their investors and face no risk, risk being the business that they're in.The final impact is the nurse practitioner  is able provide the general medical procedures necessary for quality care, but will still lack the diagnostics skills that are honed during hospital residencies and private practice.
Aug 4, 2013 10:20AM
just goes to shows  this brain dead clusterpuck is not ready for implementation. truth is, it will never be ready. the left leaning socialist crowd who support it, admit it. the excuse they use is every bill passed needed time to get the bugs worked out. so 20 years from now when y'all are still frustrated from the non care you are getting, don't worry, they will give you a quick brush off  "we're still working on it"  remark. MORONS.
Aug 2, 2013 9:39PM
Oh my stars, are they nuts.. These are not Docs.. They do not have the well rounded education that they need.. Trust me.. You are being sold a bill of goods.. They can not do what a doctor does.. Get a grip.. This is such a lie.. People don't let Obama trick you.. We need Docs.. I don't want to be seen by someone who was a nurse, book work mostly.. then more schooling for NP but no where near what they need, and the PHD this woman had is done in books.. Don't fall for this.
Aug 4, 2013 6:43PM
"With the Affordable Care Act, there will be 91,500 fewer physicians than needed in 2020, according to a study from the . That shortage shrinks to 65,100 physicians if the Affordable Care Act is not fully implemented."

No.  Not with the "Affordable Care Act."  With the American Medical Association's pressure to keep the medical school student population smaller than it was in the 1980's, there will be fewer physicians than needed.  There are two or three qualified applicants for medical school that are turned away each year for each one accepted because they artificially keep the number of doctors down.
Aug 5, 2013 10:43AM

Mirage Guy;Come up with some new lies.You`re wrong about everything.The market is up

over 100 thanks to Obama.You`re the only person I know of that doesn`t want to make

money.Do you expect us to roll with your lies?

Aug 2, 2013 9:26PM
Physician's assistants were the first iteration. NP's are a lower cost extension.
"Obamacare" has nothing to do with this. Originally, insurance companies were reluctant to pay for ether's services. Now, thanks to the lower medical care cost efforts,as well as the providing doctors need to drastically increase the number of patients seen, NP's are becoming the norm.

Aug 5, 2013 4:36AM
That's nice. If I work hard for my health insurance. Why do I want to pay for a nurse. The older we get the more exact we want our health care to be .And  it has to be right the 1st time. we don't bounce back like we used to. This entire "affordable health Care" is all smoke and mirrors. just like  Obama's green jobs and jobs in general!
Aug 2, 2013 9:30PM
They work independent only because they have a large nursing union. They can put huge pressure on Washington to push what they want. Obama is dumb enough to believe that they can act on their own.. I will tell you they cant.. I work in healthcare and I have not met one NP that should be left on their own. They have less schooling than PA'S. They were once nurses but that doesn't mean crap.. Most of them do paperwork or work on one floor most of their time as a nurse. They need more schooling and actual clinical time.  This is a bad move.. It may be cheaper people but trust me I would much rather go to a PA then to an NP.. Be careful, Obama is getting this wrong. He thinks it will help with the end result in the money spent. Please check out whoever you go and see, make sure they have at least 5 years in clinical care for whatever they are seeing you for.. (as a NP, not a nurse)...
Aug 3, 2013 8:14AM
"30 primary-care physicians, Sterns said. She compared this to the United Kingdom, Germany, and France, where there are 80, 157, and 159 physicians". Darn that Socialized Medicine, it is raising the bar for our competitive market driven system. Don't let it worry you, there are enough primary care doctors for the financially elite, and medical care is certainly not a right for those less fortunate.
Aug 4, 2013 4:48PM

Montana 10:If you hate the country, hate Obama, hate the Constitution so much why don`t

you just leave?That`s better than always whinning, crying, bellyaching and always being

bitter and hateful.We`re better off without negative hateful losers like yourself.

Aug 2, 2013 9:40PM
One more thing.. They do not have to be re certified.. PA'S have to go back and take continuing medical education classes and then get re certified every 6 yrs.. NP'S don't.. So they aren't kept up to date on new things happening..
Aug 3, 2013 9:31AM

Two things for certain about this short article: 1) the comments posted here indicate that many readers motivated to write something are far too disturbingly stupid to understand and comprehend any aspect of the affordable care act; 2) several of the comments also indicate that the writers are blowhard liars who just make up phantasy phictions about medical services.

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