Been Treated by a Physician Extender? Do You Know What One Is?

Exponential growth in the number of seniors who are aging and require medical care is expected to continue in the next 15 years and would strain even the medical system we have today. Unfortunately, that system isn’t growing along with the senior population.

What we may not know is that the number of doctors poised to provide medical care is shrinking quickly. Not only are many doctors themselves boomers and retiring from the profession, but fewer doctors are entering the medical field. Combined with a potential surge in the number of patient contacts as a result of medical insurance availability to those previously uninsured as part of the Affordable Care Act, the growth in the aging population likely will lead to a shortage in physicians nationwide. According to several different sources of statistics:

  • The Association of American Medical Colleges (AAMC) anticipates a shortage of 150,000 doctors in the next 15 years with an estimated shortfall of 63,000 doctors by 2015
  • The Association of American Medical Colleges and other sources predict a shortage of 200,000 doctors by 2025
  • The Bureau of Labor Statistics predicts that 145,000 new doctors will be needed by 2018

Fewer Doctors per Patient

The estimated physician to patient ratio is slowly declining as well. In 2010, there were 27.7 doctors per 10,000 people in the U.S. It is anticipated that the demand for physicians will be increasing, especially in those specialties that serve the senior population, such as cardiology, internal medicine, and most surgical specialties.

Many US medical schools are planning to increase their current enrollment numbers to help alleviate this doctor shortage but since medical school and full training is a lengthy process, generally taking ten to fifteen years to complete, it will be some time before the effects are felt.

Many patients in the U.S. have access to care from doctor extenders, trained medical professionals who do not hold doctor licenses. Last year there were 75,000 physician assistants (PAs) in practice and 168,000 nurse practitioners (NPs).

What Can Your Senior Expect from Physician Extenders?

A Physician Assistant (PA) is a professional who provides medical care under the direct supervision of a physician. A PA is trained in all aspects of medicine (unlike a Nurse Practitioner, who is trained in the nursing aspect) and requires a state license to practice in a variety of healthcare settings, including clinic, hospital, or other healthcare setting. A PA is not required to complete a residency, as a physician would, but must complete continuing education, as a physician would, to remain current in the field. A PA provides a broad range of medical services generally performed by a physician. PAs will perform physical exams, diagnose and treat illnesses, order and interpret tests, prescribe medications, counsel on preventive health care and may assist in surgery.

A Nurse Practitioner (NP) is an advanced practice registered nurse with additional national board certification and a state license. Depending on the state, NPs can work with a doctor or independently in their area of training. NPs will perform physical exams and assessments, diagnose problems in their specialty areas, manage chronic diseases, order and interpret tests such as blood work and diagnostic tests, prescribe treatments such as medications and therapy, provide oversight in acute, critical care and rehab settings, provide well checks including immunizations, perform or assist with minor surgical procedures and provide education and counseling about disease management depending on the guidelines in each state. A nurse practitioner is a patient advocate and focuses on preventive care, well-being and treatment options for optimal health. NPs will refer to the primary physician any person who has a complicated case or fails to respond to treatment given.

PAs and NPs can bill Medicare and Medicaid for their services if they are enrolled as providers in the Medicare system. For private insurance companies, services are reimbursed through a separate credential or directly under the name of the physician for whom they work. NPs can be paid at a lower reimbursement rate-85% vs. 50% in some states by private insurance companies.

Both of these types of medical professionals are well qualified to treat our aging seniors (and ourselves) and we will all be seeing more of them when we visit our doctor’s office or other healthcare facility.

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