Do mid-levels want to take over primary care?

A proposed solution to the primary care shortage is that mid-level providers like nurse practitioners or physician assistants will “take over” primary care as doctors exit the field.

Voila. Costs cut, problem solved.

But it assumes that these providers want to enter primary care in the first place.

Dr. Val interviews a few nurses and finds that’s far from the case:

The only problem with this reasoning is that nurses may not be willing to provide primary care services for the same reasons that physicians aren’t too keen on it: the pay is low, the workload is grueling, and there are other career options that offer better lifestyle and salary benefits.

I spoke with a group of nurses on a recent podcast about this very issue and their view was that, “we’re not suckers.”

As long as the incentives remain in place that favor specialists – higher pay and better hours – NPs and PAs will also gravitate away from generalist fields.

topics: nurse practitioner, physician assistant

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