Why mid-level providers will not take over primary care

Many health policy experts are saying that mid-level providers can help with the primary care physician shortage, which would also implicitly drive physician salaries down as PAs and NPs are paid less.

I’ve always been dubious of that assertion, mainly because they see the same bureaucratic morass that impedes primary care and subsequently, will cause them to gravitate towards specialty medicine as well.

The ACPs Bob Doherty backs that up with some numbers showing that almost half of PAs and NPs already work in specialty practices. Expect that number to only rise.

Furthermore, the number of mid-level providers is nowhere near high enough to meet primary care demand, and although it is “likely that NPs and PAs will continue to serve an important role in the provision of care, their numbers will not be sufficient to eliminate the emerging physician shortage.”

So rest assured generalist doctors, mid-levels will not take your jobs. Primary care remains a pillar of any health reform plan, as those calling the shots like Obama and Baucus even seem to realize. The only way to solve the problem will be to reform the physician payment system.

The politicians will come to realize that inevitable conclusion. Eventually.

topics: mid-levels, primary care