Nonphysician Clinicians

The Growth of Nonphysician Clinicians

If you are an avid reader of this blog, you’ve heard about nurse practitioners (NPs) and physician assistants (PAs).  What you might not know is how they popularity has grown over the past decade.  A paper by Strange (2013) cites the following statistics:

With more than 85,000 PAs and 150,000 NPs eligible to practice, their ranks now exceed the number of general and family practice MDs and are approaching the number of primary care physicians, estimated to be about 260,000.   In many communities, physician assistants and nurse practitioners are already the principal providers of primary care and their ranks are projected to grow even further.

 Using regional differences in NP and PA licensing law as econometric method for identifying exogenous variation in the supply of these nonphysician clinicians, Strange find the following:
…across all areas, greater supply of NPs and PAs has had minimal impact on utilization, access, preventative health services, and prices. However, primary care utilization is moderately responsive to NP provider supply in areas that grant non-physician clinicians the greatest autonomy to practice independently. I find no evidence that increases in provider supply decreases prices, even for visits most likely to be affected by NPs and PAs: primary care visits in states with a favorable regulatory environment for NP and PAs.
 
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