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By the year 2032, it is anticipated that there will be a shortfall of 21,100 to 55,200 primary care physicians in the United States. The Patient Protection and
Affordable Care Act, population health programs, and increased physician workload have all contributed to the shortfall, which was initially ignited by these
factors. Despite the fact that primary care physicians account for more than half of all doctor visits in the US, only about 28% of primary care physicians are
employed in the country. Recent studies have identified pay as the main contributor to the shortage of primary care doctors. Historically, doctors who
concentrate in primary care have made less money than doctors who specialize in other fields. These claims regarding compensation and the demand for a
physician to specialize in primary care are further supported by the law of supply and demand. The law of supply and demand posits that as demand for a
good or service increases, the price for that good or service also increases. Physicians were categorized as either primary care or non-primary care; with nonprimary care being specified as medical, surgical, or other specialties, and hospitalists. According to the Medical Group Management Association’s 2018
MGMA DataDive Provider Compensation report, physician workloads have remained the same despite increases in compensation. Further, physicians are
seeing less patients (Michaels, A., & Clack, L.,2021).
A number of effects on the health system are unavoidable when there is a lack of physicians to provide healthcare services to a population. These effects
include: 1) Lower quality care; 2) Time restrictions on doctor-patient interactions; 3) Increasing workload for healthcare practitioners; 4) Overworked and
stressed practitioners; 5) Unnecessarily long wait times before consultations; and 6) Higher consultation costs (Smith, Y., 2019).
The largest group of healthcare professionals are nurses. They work in a wide range of environments and treat a variety of populations. The nursing
profession plays a crucial role in providing high-quality, patient-centered, easily accessible, and reasonably priced care as the healthcare system changes as
a result of the Affordable Care Act (ACA). The Future of Nursing: Leading Change, Advancing Health” research by the Institute of Medicine (IOM) offered
suggestions for nurses’ roles in the evolving healthcare environment. The IOM’s suggestions for removing practice and care barriers are pertinent to rural
locations (Van Weel, C., & Kidd, M. R., 2018).
That is to say, if Advanced Practice Registered Nurses (including nurse practitioners) are allowed to practice to the fullest extent of their education and
training, this could help to create the workforce needed to meet the growing demand for healthcare, particularly among those residing in medically
underserved areas. (Historically, the term “nurse practitioner” (NP) was used in the literature; more recently, the term “advanced registered nurse practitioner”
(ARNP) has been designated; as a result, ARNP is used in this article.) Although efforts have been made at the federal and state levels to loosen restrictions
on ARNP practice, many states prevent ARNPs from practicing at the level for which they have been trained (Van Weel, C., & Kidd, M. R., 2018).
According to the IOM, “Collaborative models of practice, in which all healthcare professionals operate to the fullest extent of their education and training,
optimize the efficiency and quality of treatment for patients and promote the satisfaction of healthcare providers.” The IOM advises the nursing community,
other health professions groups, and policy makers to establish a common ground to remove scope of practice restrictions and increase interprofessional
collaboration in order to facilitate the formation of these models and increase accessibility to high-quality healthcare. A number of studies have contrasted
the outcomes of patients treated by ARNPs and physicians (Van Weel, C., & Kidd, M. R., 2018).
A systematic study found no differences between patients treated by ARNPs and those treated by physicians in terms of patient outcomes (as shown by
emergency department (ED) or urgent care visits, rehospitalization rates, and mortality rates) (MDs). The impact of ARNP practice regulatory rules on
population health outcomes, however, is not widely agreed upon (Van Weel, C., & Kidd, M. R., 2018).
Why is primary care so important?
Two crucial current global health policy efforts are the improvement of primary healthcare and the achievement of universal health coverage. The concept of
universal health coverage, as noted in the United Nations’ 2015 Sustainable Development Goals, is an aspiration to provide all people with access to essential
high-quality health services and to safe, effective, and affordable medicines and vaccines, while at the same time promoting health promotion, disease
prevention, health maintenance, education, and rehabilitation (Ortiz, J., et. al., 2018).