Nurse Practitioners in Primary Care

Abstract

This article reflects on the shortage of health care providers and the need to enact laws and create an environment that encourages the growth of nurse practitioners who are competent and poised to fill the primary care gap. Almost one in five Americans lack adequate access to primary health care due to shortages of physicians in their communities, leading many Americans to resort to hospital emergency rooms to meet their non-emergent medical needs and therefore higher costs on the health care system.

As availability of physicians diminishes, more patients will need to see nurse practitioners for their primary health care needs. The nurse practitioner workforce continues to grow at a healthy rate; however, inconsistent state laws, insurance reimbursement practices, and outdated notions of physician-nurse hierarchy are factors in stifling nurse practitioner independent primary care. While the passage of the Affordable Care Act reveals a recognition on the federal level of the critical role nurse practitioners play in primary care and encourages more reliance them by authorizing increased funding to various health care providers, more needs to be done by Congress, courts, state governments, and health insurers to encourage nurse practitioners to provide the critically needed primary care in America.

The article begins by presenting an overview of the trends in primary care and the primary care shortage. Next, it discusses the development of the nurse practitioner role and the scope of practice. It then delves into the obstacles placed on the nurse practitioner in primary care practice. Lastly, the article concludes by discussing the necessary next steps needed to be taken in order to facilitate nurse practitioners filling in the primary care gap within the United States.

Keywords: primary care, nurse practitioners, physician shortage, Patient Protection and Affordable Care Act

JEL Classification: K30, K39