With the pandemic highlighting the increasing shortage of nurses and allied health professionals in the most dramatic fashion, it is critical to acknowledge that the impending deficit of US-based physicians is equally destabilizing. Largely attributable to aging and population growth, a recent study by the Association of American Medical Colleges projected that by 2034, the country could see a physician shortage of between 38,000 and 124,000 medical doctors. In contrast, the job outlook for advanced practice nurses, nurse practitioners and physician assistants — collectively known as “physician extenders” — is far more favorable, as the US Bureau of Labor Statistics is projecting growth on the horizon of 45% and 31% through 2030, respectively, in the number of such jobs. This segment of clinicians will undoubtedly be an integral piece of the solution to bridge the gap in physicians that threatens to derail the healthcare delivery system.
One factor supporting the rise of physician extenders is government policy. While the introduction of legislation — such as The Resident Physician Shortage Act of 2021 — aims to provide a solution to the physician shortage by addressing funding issues within medical education, other attempts by the government are being explicitly directed toward extenders. Just this year, The Centers for Medicare and Medicaid Services executed a rule that permanently authorizes PAs to receive direct payment from the Medicare program. This move was especially significant as it eliminates the payment barriers that hindered PAs from providing coverage in federally designated health professional shortage areas, most of which are rural.
But the increased demand for physician extenders isn’t solely driven by the need to fill coverage gaps or contain costs. Now, more than ever, healthcare systems are recognizing that the recruitment and inclusion of extenders as part of the clinical staff has other benefits. The presence of physician extenders within an organization often means more efficient through-put, increased patient volume, and lower overhead and liability costs, leading to better patient satisfaction and clinical outcomes. This realization is evidenced in the 2021 Review of Physician and Advanced Practitioner Recruiting Incentives report, published by Merritt Hawkins, a division of AMN Healthcare, where it was reported that for the first time in the report’s 28-year history, nurse practitioners were the most sought-after type of medical provider. The shift, while unprecedented, isn’t entirely shocking given the autonomy and flexibility that lies within advanced practice nursing, most of which is focused on delivering primary care.
Use of physician extenders is growing because of their valuable role in healthcare delivery. Although there are some differences in scope and independence between NPs and PAs, which vary by state, both can provide a higher level of care than other types of clinicians and they can sometimes do so relatively independent of a physician. Beyond providing coverage in areas that have historically been short on providers due to geography, physician extenders supplement the delivery system by acting as the senior medical personnel in a number of environments, including, but not limited to outpatient and clinic settings. They are often able to assess, treat and diagnose patients in the absence of a licensed medical doctor. And, in many instances, have full prescribing rights.
Though the roles of nurse practitioners and physician assistants have expanded over time, the shared original purpose, to assist with physician shortages, has remained largely intact since the inception of each in the 1960s. There is no indication that either role will become less prevalent in the coming years. In fact, all signs point to a continued increase in need and demand for both professions. With almost half of physicians expected to hit retirement age in the next 10 years, the use of physician extenders may be the key to slowing down the physician shortage crisis.
As with any staffing challenge facing healthcare providers, the healthcare staffing industry stands ready to address these hiring needs today and into the future. Healthcare staffing leaders will be wise to prepare and plan for the increased role that physician extenders are likely to play. For information on firms that specialize in the recruitment of physician extenders, please check out SIA’s Largest Healthcare Staffing Firms report.
