Primary Care Is Dead. Long Live Primary Care!

[Carson-Newman Online]

Primary care has recently become a hot subject in the healthcare industry. Patients and care providers are searching for new ways to make the healthcare system perform at optimal levels at a reasonable cost. Yet excessive health insurance costs complicating the process of receiving affordable healthcare have not led to the death of primary care — they have contributed to its rebirth. Healthcare publication NEJM Catalyst estimates that 55 percent of the 1 billion physician office visits that occur in the United States annually are for primary care services.

With so many patients at their doors, healthcare organizations have been forced to get creative in how they package and deliver primary care. Recent legislation that allows family nurse practitioners to deliver primary care services in many states is reshaping the way people fulfill their basic healthcare needs. Additionally, healthcare providers are exploring alternatives to traditional primary care, such as direct primary care, and these new models are achieving widespread acceptance in some areas. But will all of these factors be enough to keep primary care alive?

The Basics of Primary Care for Nurse Practitioners

Before reading about the future of primary care, it is important to learn exactly what primary care is and what roles nurses, physicians and other healthcare providers play in its delivery. Primary care is generally any basic care that doesn’t require complex treatment from a specialist.

Here are some examples of primary care services:

• Health promotion — encouraging patients to make healthier decisions
• Disease prevention — teaching patients how to avoid diseases
• Health maintenance — explaining to patients how they can actively maintain their personal health
• Counseling — offering advice to patients who need guidance on health-related topics
• Patient education — showing patients how to properly use medications and care for themselves
• Diagnosis — identifying the root causes of patients’ health issues
• Treatment — taking action to heal patients through medical interventions

Is Convenient Care the Same as Primary Care?

Convenient care puts an entrepreneurial twist on the traditional primary care delivery model in which a patient goes to a hospital or healthcare facility and speaks with a doctor or nurse. This new model has already proved to be popular, as there are currently more than 2,800 convenient care offices open in the U.S. At these clinics, people without access to primary care can receive basic treatments. These facilities cater to young people and others who rarely need medical care and aren’t likely to schedule regular checkups; however, convenient care is causing a slight rift in the healthcare community. On one hand, convenient care is allowing some to receive life-improving treatments more conveniently. On the other hand, some feel that the reliance on walk-in clinics and the absence of developing long-term relationships with a nurse or doctor could potentially reduce the quality of care. Taking that aspect into consideration, it’s unlikely that convenient care will dethrone primary care.

The Rise of Direct Primary Care

Modernization of the healthcare industry has opened the door for innovative organizations to start offering subscription-based healthcare memberships. Direct primary care practices charge periodic membership fees in exchange for basic medical visits. For many Americans, this model is more affordable, but it is still a new concept. As of March 2018, 790 direct primary care practices were operating in the United States. To put that number into perspective, there were only 125 practices in the whole country in June 2014. Evidently, direct primary care will be an important topic for healthcare thought leaders to discuss in the future.

The Rebirth of Primary Care Lives With the Family Nurse Practitioner

Family nurse practitioners are the most prevalent primary care providers, as their education most often prepares them to work with all patients, regardless of sex, gender and age. The American Association of Nurse Practitioners concludes that nurse practitioners typically provide equal- or higher-quality care at a lower cost than physicians and other healthcare providers. Family nurse practitioners are essential to providing more of the population with access to critical primary care services. For example, rural communities normally lack consistent access to healthcare facilities and providers. Because of this, primary care nurse practitioners are more likely to work in rural areas than other primary care providers.

By continuing their education with a Master of Science in Nursing, working nurses can position themselves to become family nurse practitioners. The career path typically includes earning an MSN, gaining work experience, and passing one of the certification examinations such as Family Nurse Practitioner, for example, offered by a U.S.-based nurse certifying board.

Primary Care Nurse Practitioners Have More Time to Invest in Their Patients

One of the mainstays of primary care is that patients typically visit the same healthcare provider on a regular schedule. As they continue receiving treatment from this same doctor, they foster a relationship that can be useful for identifying and resolving hidden health issues. Unfortunately, the United States is facing a shortage of physicians, and as a result, most physicians lack the time and resources to know their patients well. The amount of work attributed to each physician also leads to a drop in the quality of the services physicians deliver. In turn, there is an urgent need for nurse practitioners to administer primary care themselves.

Primary care isn’t dying — that’s for sure. Parts of it are expanding, while others are being entirely reformed. Career-driven nurses can contribute to changing the way patients receive basic care by becoming licensed family nurse practitioners. Start by earning a Master of Science in Nursing and then fulfill the state-specific licensing requirements.

What are your thoughts about family nurse practitioners and the future of primary care? Please share your comments below!

Sources:

American Academy of Family Physicians, Primary Care

American Association of Nurse Practitioners, “Nurse Practitioners in Primary Care”

Becker’s Hospital Review, "7 Things to Know About the Rise of Fee-Based Direct Primary Care"

Becker’s Hospital Review, "Millennials Are Upending the Primary Care Model: 4 Things to Know"

Morning Consult, "Primary Care Is Dead!"

NEJM Catalyst, “Changing How We Pay for Primary Care”

Seattle Times, "Nurse Practitioners Stepping Up as Demand for Doctors Outpaces Supply"

Washington Post, "For Millennials, a Regular Visit to the Doctor’s Office Is Not a Primary Concern"

[Dodongo, APRN, NP]

https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/primary-care-national-projections2013-2025.pdf

The projected increase in primary care NP supply (93 percent) exceeds the increase in demand (19 percent) by 42,500 FTE (62 percent of 2025 demand) primary care NPs in 2025. All four U.S. Census Bureau regions are expected to see primary care NP supply exceed demand in 2025.

[spotangel, DNP, RN, NP]

Primary care is definitely staying and is the way to go. Trust and consistency are 2 big factors when we assist our patients.Prevention is the name of the game and the nurses are in the forefront.