The Decline of Physicians: Do we really need them anymore in Primary Care?

Published

Legislature Votes to Make NP Payment Parity Law Permanent - Nurse Practitioners of Oregon

Oregon equal pay for equal work law has been signed into law in an independent practice state with NP's and PA's getting paid FULL amount from private insurance. This means that a new grad NP's will be paid the same amount as an attending family physician and psychiatrist and also have the same rights and scope of practice as a family physician and psychiatrist.

With the tremendous push for equal pay and for autonomy for PA and NP, is there any reason for medical students to want to go into primary care anymore? I guess my question is, it seems so bizarre that someone would put themselves through hell when they could become a competent provider through the NP route or PA route.

So do you think with these new laws, PA's and NP's will ultimately lead primary care? will these laws drive away medical students from primary care? Is it financially reasonable for a medical student to become a family physician in an equal pay state?

As an sNP, I'm incredibly thrilled and happy at how much progress our profession has made. However, I also understand how some medical students hoping to go into family medicine can feel cheated and grumpy about it. What are ya'll thoughts?

Up Vote Up Vote ×
Specializes in Family Nurse Practitioner.

For the love of Pete can we lay off the self-inflated NP BS and doc bashing?

Up Vote Up Vote ×

No, I don't think so. I don't think everyone does what they do for image and status and wages. I think some people enjoy primary care and preventative care (like myself for example!) so I do think that there'll still be medical students who will go into medicine and not feel "cheated" or "grumpy" about it.

Up Vote Up Vote ×
Specializes in Healthcare risk management and liability.

In my ambulatory clinics, where we have 160,000 medical encounters per year, there are a lot of patients who only want to see 'a real doctor' and they perceive being seen by a NP or PA as receiving a lower standard of care. So regardless of legislation, there are always market forces dictating provider supply and demand.

Up Vote Up Vote ×
Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Well, one way to evaluate this is to look at annual residency program matches. In the last two years, residency matches to Family Practice programs continue to be sustained with an actual increase in positions offered and over 40% of slots filled by US medical school grads. I wouldn't call that a decline in interest.

Press Release: Results of 216 NRMP Main Residency Match Largest on Record as Match Continues to Grow |

Press Release: 215 Residency Match Largest on Record with More Than 41, Applicants Vying for Over 3, Residency Positions in 4,756 Programs |

Up Vote Up Vote ×

Wow. There are more people applying than residnecy spots? How is that possible..... we have a physician shortage so why do they keep it so low on purpose tou have toask.

Up Vote Up Vote ×
Wow. There are more people applying than residnecy spots? How is that possible..... we have a physician shortage so why do they keep it so low on purpose tou have toask.

To protect their profession from becoming over-saturated and easy for anyone to get into, unlike Nurse Practitioners have.

Up Vote Up Vote ×
Legislature Votes to Make NP Payment Parity Law Permanent - Nurse Practitioners of Oregon

Oregon equal pay for equal work law has been signed into law in an independent practice state with NP's and PA's getting paid FULL amount from private insurance. This means that a new grad NP's will be paid the same amount as an attending family physician and psychiatrist and also have the same rights and scope of practice as a family physician and psychiatrist.

With the tremendous push for equal pay and for autonomy for PA and NP, is there any reason for medical students to want to go into primary care anymore? I guess my question is, it seems so bizarre that someone would put themselves through hell when they could become a competent provider through the NP route or PA route.

So do you think with these new laws, PA's and NP's will ultimately lead primary care? will these laws drive away medical students from primary care? Is it financially reasonable for a medical student to become a family physician in an equal pay state?

As an sNP, I'm incredibly thrilled and happy at how much progress our profession has made. However, I also understand how some medical students hoping to go into family medicine can feel cheated and grumpy about it. What are ya'll thoughts?

I think you're dreaming. Take a reality check and research the differences in physician education and training and NP/PA education and training. Compare four years of medical school, residency, internship, fellowships, physician clinical hours, with NP/PA education/training.

Up Vote Up Vote ×
Specializes in Healthcare risk management and liability.
Wow. There are more people applying than residnecy spots? How is that possible..... we have a physician shortage so why do they keep it so low on purpose tou have toask.

Shortage of residency slots may have chilling effect on next generation of physicians | TheHill

There are an insufficient number of residency slots. Federal funding of the slots has not kept pace with the increasing number of graduates.

Up Vote Up Vote ×
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Wow. There are more people applying than residnecy spots? How is that possible..... we have a physician shortage so why do they keep it so low on purpose tou have toask.

Residency programs are partially funded by Medicare, Medicaid, and the VA, hence, are subject to limitations of the national budget. Physician lobby groups do seek to add more residency slots.

I think it's more in terms of the establishment of new medical schools that gets intense scrutiny from LCME but there has been a number of new med schools that have opened in the last 5-10 years.

Also, you would have to look at the actual demographics in those statistics. US med school grads had a 93.8 match rate in 2016 with 79.2% matching into a program they listed as one of their top 3 choices. IMG's had a 53.9% match rate.

http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

Up Vote Up Vote ×
Specializes in Adult Internal Medicine.
I think you're dreaming. Take a reality check and research the differences in physician education and training and NP/PA education and training. Compare four years of medical school, residency, internship, fellowships, physician clinical hours, with NP/PA education/training.

Have you compared them in terms of outcomes? What does the extant data demonstrate?

Up Vote Up Vote ×
Specializes in Family Nurse Practitioner.
Have you compared them in terms of outcomes? What does the extant data demonstrate?

Boston how do you think the outcome data will fare 5, 10 years down the road with the current trend of schools retaining undergraduate students through NP without ever having worked as a RN?

Up Vote Up Vote ×
+ Join the Discussion