Physician and/or Nurse Labor Shortages
Kirch, & Petelle, K. (2017). Addressing the physician shortage. JAMA : The journal of the
American medical association., 317(19), 1947–1948.
https://doi.org/10.1001/jama.2017.2714
This article discusses the physician shortage in the United States, which has been getting worse
year after year and is expected to get worse in the coming years. According to current
projections, the US population will grow by 12% to 359 million between 2015 and 2030, with
the population aged 65 and older expected to grow by 55%. With 10,000 Americans turning 65
every day, the aging population will drive increased demand for health-care services over the
next few decades. According to the recently released 2017 update1 of annual physician
workforce projections, the United States will face a physician shortage of between 40,800 and
104,900 by 2030. Surgical specialty workforce projections are particularly concerning, with a
projected shortfall of between 19,800 and 29,000 surgical specialists by 2030. Only 6000 to
10,000 physicians would be lost in the future. Regardless of the ACA's future, physician
shortages, particularly in certain specialties, are likely to persist. (Kirch & Petelle, 2017)
Gadbois, E. A., Miller, E. A., Tyler, D., & Intrator, O. (2015). Trends in state regulation of
nurse practitioners and physician assistants, 2001 to 2010. medical care research
and review, 72(2), 200–219.
https://doi.org/10.1177/1077558714563763
Primary care provider shortages in the United States started to increase when the Affordable Care
Act and Patient Protection were put in place. Because of this, uninsured residents can not get the
primary care they need. One in five Americans resides in areas with a primary care provider
deficit, where there are more than 2,000 people per primary care practitioner. This ratio is
unlikely to change in the near future without coordinated effort. Despite accounting for 56% of
medical visits, only 37% of physicians work in primary care. In addition, only one out of every
four medical students plans to work in primary care. (Gadbois, E. A., Miller, E. A., Tyler, D., &
Intrator, O.) (2015) Nurse Practitioners and Physician Assistants can help alleviate the primary
care physician shortage by reviewing state regulations and allowing them to practice with fewer
restrictions.
Morgan. (2019). Predicted shortages of physicians might even disappear if we fully
account for PAs and NPs. JAAPA : Official journal of the American academy of
physician assistants., 32(10), 51–53.
https://doi.org/10.1097/01.JAA.0000580580.89002.f4
Healthcare provider shortages can shortchange patients, while provider overproduction costs
society. The Association of American Medical Colleges' most widely publicized physician supply
and demand projections, commissioned annually, consistently predict dire physician shortages.
For example, the projections assume that one primary care PA or NP contributes one-fourth of
what a physician does. If workforce projections were based on evidence-based productivity
estimates, the predicted physician shortages would be much smaller, if not non-existent.
(Morgan) (2019). The third exhibit in the report shows the physician supply and demand lines
converging in 2024 for primary care projections that include NPs and PAs as substituting for
one-half of a physician. The frequently reported projected physician shortages would be
significantly reduced, if not eliminated, if estimates employed more accurate substitution ratios
for NPs and PAs.
Pressler, J. L. & Kenner, C. A. (2009). The NNP/DNP Shortage. The journal of perinatal
perinatal & neonatal nursing, 23 (3), 272-278.
https://doi.org/10.1097/JPN.0b013e3181b0bd79
The shortage of neonatal nurse practitioners has been a long-standing issue. NNP shortage is
increasing as a result of retiring and aging NNPs. A lack of experience is another reason why the
vacancies cannot be filled. Another reason for the shortage of NNPs is a lack of education. The
training challenge is exacerbated by a lack of experienced NNPs to precept students during their
practicum experience. NNP students must complete at least 600 hours of supervised practicum.
Completing this large number of clinical hours makes it difficult for students to work full-time in
nursing practice. To address the shortage of NNP/DNP faculty, innovative solutions must be
implemented. To have a sufficient number of faculty, NNP programs may need to share faculty
via distance education. Faculty from multiple programs, rather than just two, may need to
collaborate and work as a team to prepare new NNPs and DNPs more efficiently. To address the
diverse patient groups served by NNPs, more extensive interdisciplinary collaboration is
required, which may be perceived as a paradigm shift in the NNP educational approach.
Auerbach, D. I., Chen, P. G., Friedberg, M. W., Reid, R., Lau, C., Buerhaus, P. I., &
Mehrotra, A. (2013). Nurse-managed health centers and patient-centered
medical homes could mitigate expected primary care physician shortage.
Health Affairs, 32(11), 1933-41.
http://ezproxy.liberty.edu/login?qurl=https%3A%2F%2Fwww.proquest.com
%2Fscholarly-journals%2Fnurse-managed-health-centers-patient-centered
%2Fdocview%2F1458312847%2Fse-2
Since the Affordable Care Act increased patient demand for care, multiple forecasts have
predicted a primary care shortage. The potential impact of two of those innovations, the patient-
centered medical home and the nurse-managed health center, on forecasts of primary care
provider shortages or surpluses, is highlighted in this article. The estimated surpluses and
shortages of providers were calculated using a variety of scenarios that varied the prevalence of
the medical home and nurse-managed health center models, as well as the size of the medical
home panel. According to projections, if nothing changes in primary care delivery, the United
States may face a significant shortage of primary care physicians and a surplus of nurse
practitioners and physician assistants by 2025. If the potential for increased panel size under the
medical home's team-based approach is eventually realized, the result could be an adequate
supply of physicians, even after accounting for increased demand due to the implementation of
the Affordable Care Act. (Mehrotra, A.) (2013).
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