Primary care providers treat patients of many ages with a variety of health problems. Sometimes called “family doctors,” physicians who have typically filled this role are aging and many of their younger counterparts aren’t willing to fill their shoes. Over the next decade, one out of every three physicians will retire, and by 2020, the physician shortage is estimated to be between 24,000 and 200,000. Adding to the problem is the surge of Americans who have entered the health care system with the introduction of the Affordable Care Act.
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While staffing challenges exist across the board, rural primary care is facing an extraordinary struggle. Many physicians are less willing to practice in rural settings for a variety of reasons including professional isolation, lack of job opportunities for spouses, and limited time off. Of the 2,050 rural counties in the country, 77 percent are primary care health professional shortage areas and 165 of these counties had no primary care physician at all.
Nurse Practitioners Help Meet Demand, Provide Quality Care
To help resolve this primary care shortage, communities are turning to the care of nurse practitioners and physician assistants. Unlike physicians, 18 percent of nurse practitioners choose to work in rural settings every year and enjoy a variety of benefits they may not find as easily in an urban area.
- Greater autonomy. Rural areas are often short on specialists — patients may need to drive 20-60 miles one way for their care. This means mid-level providers like nurse practitioners have a greater opportunity to manage complex health problems than they would if they had a physician nearby.
- Better job satisfaction rates. Nurse practitioners who work in rural settings have higher job satisfaction rates compared to other areas of the United States. Taking time to know their patients on a more personal level helps patients feel more satisfied with their care and helps practitioners feel happier with their jobs.
- Lower cost of living and better salaries. Even though a trip to the grocery store may be 50 miles away, NPs who work in rural settings are often reimbursed well enough to offset the inconvenience. Thanks to a $60,000 tuition reimbursement from the National Health Services Corp (NHSC), nurse practitioners who work just two years in a rural setting can offset a significant portion of their educational costs.
Positive Outcomes for Patients
In addition to personal and professional benefits for nurse practitioners, data also shows positive clinical outcomes for the patients they treat. In a study by the Institute of Medicine (IOM), access to primary care was higher when nurse practitioners were involved, and hospitalization rates were lower for elderly patients. Growing evidence also shows that nurse practitioners spent more time consulting with their patients, had higher patient satisfaction scores, and delivered quality care comparable to that of physicians.
Growing Demand for Nurse Practitioners
The nation is looking to nurse practitioners to help fill the primary care gap in areas where physicians are scarce — which in turn creates a growing demand for nurse practitioners. There are 155,000 nurse practitioners in the United States, and that number is expected to increase to 244,000 by the year 2025, according to the American Association of Nurse Practitioners. Nurses living in rural areas who are seeking to advance into a nurse practitioner role have more educational options than ever, allowing them to earn a Master of Science degree in Nursing without having to uproot their lives or move to attend a distant on-campus program.
Embracing Change and Moving Ahead
The scope of practice and the autonomy of the nurse practitioner will vary from state to state. Across the U.S., scores of legislation is under consideration to better outline practice guidelines for NPs and delineate responsibilities. Despite these changes, nurse practitioners will continue to provide quality care on the front lines of rural America — working in clinics, small hospitals or mobile units to provide primary care to thousands of rural men, women and children.
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