Doctoral Student Co-Authors Piece on NPs and Primary Care for NEJM
Second-year doctoral student Laurie Bauer, RN, MSPH, has co-authored an article titled “Rethinking the Primary Care Workforce—An Expanded Role for Nurses,” which appeared in early September in the New England Journal of Medicine (NEJM). Bauer and co-author Thomas Bodenheimer, MD, posit that “the [primary care] physician’s role will increasingly be played by NPs,” and that “patients with chronic conditions will receive some of their care from registered nurses (RNs) functioning as care managers.”
The paper notes that a growing gap between the population’s demand for primary care and the number of primary care physicians, an increase in physician retirees that exceed the number of new entrants and a near tripling of NPs entering the workforce between 2003 and 2014 has led to more NPs in physician roles, particularly in rural communities. In addition, the number of RNs is expected to grow by 33 percent between 2012 and 2025.
How NPs and RNs are Filling the Gaps
The paper observed that RNs are already assuming three significant emerging primary care functions, including:
- Managing care for chronic disease patients
- Leading complex care management teams
- Coordinating care between primary and other providers—setting transitions (hospital to home, etc.)
As for NPs, despite numerous findings that they deliver safe, high quality primary care, some barriers remain to their fully filling in the gaps. The article concludes, however, “the shortage of primary care physicians and the increasing prevalence of chronic diseases are powerful forces pushing primary care toward stronger NP and RN participation. It’s fortunate that the growth in the supply of NPs and RNs enables us to rethink who does what in primary care.”