Who’s On First: A Look at Workforce Projections
It's impossible to predict the future—especially of health care—but we can, without question, anticipate changes and hurdles as the baby boomer population ages. How can we combat or curtail these challenges?
Which brings us to perhaps the most important aspect of this discussion: What actions need to be taken to mitigate the possible damage of a physician shortage? Here are some recommendations for a variety of stakeholders:
Educators should enhance their competency-based curriculum to enable NPs and PAs to move through their programs at a faster stride (again, without sacrificing valuable learning time) and get into practice sooner.
Accreditors should review current standards and remove barriers to allow education programs to create innovative curricula that help NPs and PAs gain the knowledge (and experience) they need to move into practice.
Regulators should ensure that NPs and PAs are able to practice to the fullest extent of their license and scope of practice (ie, full practice authority, scope of practice determined at the practice level). Barriers should be removed to allow these clinicians to function in rural and underserved regions of the country (eg, adaptable collaboration requirements).10 (For a different perspective on PA autonomy, see here.)
Policymakers should rally around the removal of barriers to postgraduate residencies, which would sustain and possibly increase the physician supply. Reimbursement, particularly in Medicare, should be re-evaluated to assure that all providers are reimbursed for same services. Lack of parity in reimbursement infers a difference in quality that is just not the case.
Practicing NPs and PAs should step up to the plate and volunteer as preceptors to give NP and PA students the opportunity to learn from the best and most experienced.
Physicians should seek out alternatives to retirement from medicine (ie working part-time, becoming an educator). Expanding the period of clinical practice may forestall, or even prevent, some of the shortage—at least, in the short-term.
There are those who say that a provider shortage does not exist and that those crying out about it have a vested interest in expanding medical school output. Others acknowledge the shortage but worry that increasing the supply of NPs and PAs will ultimately “devalue” individual providers (ie, drive down salaries). One thing, however, is certain: As Danish physicist Niels Bohr said, “Prediction is very difficult, especially if it’s about the future.”
What are your thoughts and ideas about the health care workforce and the increasing demand for care? Please share them with us by writing to PAEditor@frontlinemedcom.com.
