Independent Practice for Physician Assistants and Nurse Pracitioners.

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As healthcare costs continue to increase, access to quality care has never been greater. Failure to improve access to care has led to opioid addiction, and unaddressed mental illness, leaving millions of Americans lacking the medical and psychiatric care they so rightly deserve.

Marketwatch states that opioid addiction costs $500 billion annually (here), and claimed close to 60,000 lives last year according to the NYT (here).

The NIMH states that upcoming costs of mental health worldwide illnesses are expected to exceed all combined costs of diabetes, respiratory disorders, and cancer at $6.0 trillion worldwide by 2030 (here). Not only that, approximately 43.5 million Americans endure some mental illness, with approximately 42,000 deaths due to suicide in the United States (here).

The ability to increase access to care to those most desperately in need is simple: allow physician assistants and nurse practitioners to practice independently in the primary care setting, instead of being burdened by restrictions placed on them bureaucratic and political entities. Physician assistants and nurse practitioners role was created by doctors at Duke University and the University of Colorado in the 1960s in response to shortage of healthcare providers. Since that time, PAs and NPs are found in almost every specialty and are allowed to practice, treat, and prescribe the same as doctors.


The AAMC shows that there will be over 100,000 shortage of providers by 2030, largely due to the fact that most doctors are avoiding going into primary care. Ironically, they largely argue against PA and NP practicing independently due to the flawed argument that they will take MDs positions (here).

Additionally, many physicians argue that they are able to provide superior care when compared to their physician assistant and nurse practitioner counterparts. A recent study published by NCBI in 2017 actually shows there is no statistical difference among MDs/PAs/NPs, with both PAs and NPs actually providing more healthcare counseling than MDs (here).

PAs and NPs are also a more cost effective option when it comes to paying for healthcare. An article in the New York Times stated that the annual cost of training physicians was close to $15 billion, which includes 4 years of medical school, in addition to 3-5 years of residency. To put it in perspective, you can train almost 3 PAs to go into family medicine during the same time to train 1 MD (here)

Additionally, most physician assistant programs that are affiliated with highly reputable medical schools are enrolled in many of the same classes (Duke, Wake Forest, etcetera…), and both require the same rigorous pre-requisite classwork prior to admittance.

Clearly, there is a shift away in how healthcare has traditionally been managed, and no one expects a PA or NP to be operating on a neurosurgical patient independently without proper training or oversight. However, PAs and NPs are already working throughout almost every corner of healthcare, and have proven that they are capable of providing high-quality care. CVS is so confident in their level of care, that PAs and NPs are staffed at all their 1,100 stores (with plans on expansion) to provide healthcare to the neighboring communities.

Hopefully, by reading the material presented, you have a clearer picture of the value that PAs and NPs bring to the team. No one group is every going to solve the myriad of problems currently affecting the healthcare system, but it is unfortunate to under-utilize such a tremendous resource due to politics. So call your local and state representatives and tell them that you support all providers, including physician assistants and nurse practitioners!



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