U.S. Primary Care Provider Needs: An Analysis of Workforce Projections and Policy Implications

Authors

Jana Zwilling, College of Nursing & Professional Disciplines, University of North Dakota, Grand Forks, ND, USA.
Barbara Wise, Division of Graduate Studies in Nursing, School of Nursing, Indiana Wesleyan University, Marion, IN, USA.
Christine Pintz, School of Nursing, George Washington University, Washington, DC, USA.
Mary Beth Bigley, National Organization of Nurse Practitioner Faculties, Washington, DC, USA.
Brenda Douglass, Johns Hopkins School of Nursing, Baltimore, MD, USA.
Tracie W. Kirkland, Department of Nursing, University of Southern California, Los Angeles, CA, USA.
Stefanie La Manna, Ron and Kathy Assaf College of Nursing, Nova Southeastern University, Fort Lauderdale, FL, USA.
Donna Lynch-Smith, UTHSC College of Nursing | Department of Acute and Tertiary Care, University of Tennessee Health Science Center Memphis Tennessee, Memphis, TN, USA.
Sheryl L. Mitchell, College of Nursing, University of South Carolina, Columbia, SC, USA.
Sharon L. Stager, Department of Nursing, Salve Regina University, Newport, RI, USA.
Julia Steed, School of Nursing, Vanderbilt University, Nashville, TN, USA.

Document Type

Journal Article

Publication Date

8-21-2023

Journal

Policy, politics & nursing practice

DOI

10.1177/15271544231190606

Keywords

health care quality; health resources; health services accessibility; nurse practitioner; policy; primary care; workforce

Abstract

The primary care (PC) physician workforce has consistently been projected as requiring additional numbers to meet the needs of the U.S. The Health Resources and Service Administration (HRSA) has reported the PC nurse practitioner (NP) workforce to be 90,000 NPs more than required to meet the PC needs of the U.S. With both clinician types contributing to the PC workforce in the country, it is difficult to understand such an oversupply of NPs with continued deficit in PC physicians. The purpose of this study was to investigate results and methods used for HRSAs current PC workforce projections and compare those with the same used for Bureau of Labor Statistics (BLS) and American Association of Medical Colleges (AAMC) projections. Methods included a review of technical documents, dashboards, and published reports. Interviews with subject matter experts were also completed. Projections were found to differ significantly, as did data and assumptions. Two of the three projections modeled physicians as the sole provider of PC. An integrated model gives the most comprehensive and accurate picture of PC workforce needs. The utilization of NPs as PC providers has been demonstrated to be safe and effective, with the potential to alleviate predicted shortages, improve patient care outcomes, reduce cost, and address PC inequities. Implications include improving workforce data, creating projections that mirror clinical integration in PC, adjusting workforce preparation funding, incentivizing interprofessional collaboration in research, addressing barriers to practice among non-physician providers, and leveraging growth in the NP workforce.

APA Citation

Zwilling, Jana; Wise, Barbara; Pintz, Christine; Bigley, Mary Beth; Douglass, Brenda; Kirkland, Tracie W.; La Manna, Stefanie; Lynch-Smith, Donna; Mitchell, Sheryl L.; Stager, Sharon L.; and Steed, Julia, "U.S. Primary Care Provider Needs: An Analysis of Workforce Projections and Policy Implications" (2023). GW Authored Works. Paper 3219.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3219

Department

Nursing Faculty Publications