WSJ: The Nurse Practitioner Will See You Now...
Started by drusso
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Where I live (close to nowhere) the FP MDs do not take new patients. Their practices are full. To see a specialist you need a referral. So the only choice other than get on a years long waiting list (if even offered) is to contract with a concierge doctor. That is what I did but I have enough money to do that. Most local people do not. So they go to a NP in a box. Which is what I did until I found a concierge doc. The NP seemed pretty good. Efficient, conscientious, and the billing was simple. I think they are the future of USA primary care in rural areas or where I live they are primary care for probably most people. BTW primary care MDs state that they cannot earn enough to sustain a decent lifestyle here.
Let’s see what AI does here on that front
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While I agree with your point that the best "usage scenario" appears to be rural primary care, that also raises the concern that giving rural populations care by NPs while urban populations get access to MD GPs would lead to inequalities and different quality of care.
- Primary Care Focus: Nearly half (47.2%) of all employed NPs provide primary care in their principal roles.
- Workforce Share: The share of all clinicians practicing primary care (physicians, NPs, and PAs combined) has stayed around 28%.
- Rural & Underserved Areas: NPs are heavily utilized in rural areas, where the ratio of primary care physicians per capita is often lower. Over 53% of U.S. primary care practices employ NPs, with those utilizing NPs being much more likely to operate in rural and low-income communities.
- However, the share of primary care visits delivered by non-physicians (including NPs and physician assistants) is growing rapidly, with non-physicians currently delivering roughly a quarter of all health care visits nationwide. (Google AI)
I believe the nursing and NP organizational leadership would strongly argue that their US no difference in care bw them and MDs. That’s the scariest part…and they’re lobbying much harder than we are
Best predictive factor for me has been years of experience in primary care. I think being exposed to all aspects of medicine gives them a more doctor-like skill set (obviously not true for all but I’ve had several who have been great - efficient, smart, and good clinical judgement.
I’m starting to do the same slowly.
Replacing my NPs with PAs
doesn't matter which one you replace... both will replace us soon enough
PAs seem to be better team players from my experience
Patients don’t have a choice. There are a lot of family docs that don’t respond to urgent requests. “I have a small abscess on my buttock.” Ok, the doctor can see you in 3 months.
“hey, my doctor left. My visit with the new doctor isn’t for 3 months. Can he refill my BP medications?” Ok, we have a cancelation so you can actually be seen in 4 months.
“That is further out???” Yes, the doctor cancel that day you were scheduled.
I take care of so much stuff for my patients do to unresponsive primary care. A lot of it though are the rural practices. I don’t have to do it for the ones in the metro much. I did have a scenario where I refilled meds, after the patients midlevel left and the doctor taking over wouldn’t refill the meds or move up the patients appointment. And I am almost certain that the doctor was the midlevels supervising physician.
“hey, my doctor left. My visit with the new doctor isn’t for 3 months. Can he refill my BP medications?” Ok, we have a cancelation so you can actually be seen in 4 months.
“That is further out???” Yes, the doctor cancel that day you were scheduled.
I take care of so much stuff for my patients do to unresponsive primary care. A lot of it though are the rural practices. I don’t have to do it for the ones in the metro much. I did have a scenario where I refilled meds, after the patients midlevel left and the doctor taking over wouldn’t refill the meds or move up the patients appointment. And I am almost certain that the doctor was the midlevels supervising physician.
