Over the past year, there has been a lot of focus on the healthcare professions as they struggle to deal with the COVID-19 pandemic. One of the things that has been brought to light during the pandemic, is the fact that we are likely to face a shortage in the number of physicians. One report suggested that by 2033, there could be a shortage of 139,000 physicians in the US.
Physicians are over-burdened and under-resourced, and a change to how the medical professions are organized is needed in order to lighten the load. This is starting to happen with the empowerment of family nurse practitioners to use their extensive qualifications and training, to step into some of the roles that physicians have previously played. By allowing family nurse practitioners more autonomy, patients are able to access higher quality care more quickly.
What is causing the physician shortage?
The physician shortage is being caused by a number of different factors. The so called ‘baby boom’ generation is living longer and healthier lives than the generations that came before them, which means that there are more people requiring healthcare into old age than there has been previously.
This is also coupled with the increase in chronic conditions such as diabetes and obesity, which put an additional strain on the healthcare system.
The shortage of physicians has a further knock-on effect, because qualified physicians are needed in order to train the next generation of physicians. If there are not enough physicians in the first place, then it makes it more difficult to give new ones the training that they need.
What is a family nurse practitioner?
A nurse practitioner is a registered nurse who has undertaken extensive training at the postgraduate level within a specialist branch of medicine, allowing them to operate as an expert within their chosen field.
A family nurse practitioner is a nurse practitioner who has chosen to specialize in the field of family medicine. The role of a family nurse practitioner is similar to that of a family physician. They will work with patients of all ages, throughout their lives, and provide both diagnosis and treatment for illness, as well as education on how to promote a healthier life.
In some states, family nurse practitioners operate with complete autonomy. This means that they are authorized to order tests, prescribe medicines, make a diagnosis and recommend treatments for their patients. In other states, family nurse practitioners must operate under the supervision of a physician. They still carry out the same tasks, but they will need to report to their supervising physician and will not have full authorization.
This need to report to a physician is seen by some as an unnecessary bottleneck that is preventing nurse practitioners from making the most of their education and experience, and that is causing delays in patients receiving care.
How can nurses become family nurse practitioners?
In order to become a family nurse practitioner, you must first be a registered nurse, which usually means being qualified at degree level and being licensed by your state.
There is a move towards all nurses having their bachelor of science in nursing (BSN) rather than their associate degree in nursing (ADN), so if you do not have a BSN you may need to do a conversion course before you can undertake further study to become a nurse practitioner.
Once you have your BSN you can enrol on a master of science in nursing (MSN), with the specialization that you wish to take. You can go straight from the undergraduate study into your masters, but many people like to work for a while first to get a feel for which specialist area they would like to work in.
Once you have your MSN, you will need to have recorded a certain number of supervised clinical hours. Once you have this, you can apply for licensure as a nurse practitioner from your state. The actual requirements for licensure vary between states, so it is a good idea to check with your state licensing board to see what is required.
For a detailed guide on becoming a nurse practitioner, please click here.
How family nurse practitioners help with the shortage
There are two key ways in which nurse practitioners are key to resolving the physician shortage.
Firstly, the more autonomy that family nurse practitioners are given, the more they can treat patients without ever needing to involve a physician. This means that the load on the physicians is lightened, which in turn should mean that not so many physicians are needed. This is why there is a focus from the AANP (American Association of Nurse Practitioners) on giving nurse practitioners more autonomy in those states where they must still work under the supervision of a physician.
Giving autonomy to nurse practitioners also benefits patients and improves care. As nurse practitioners have gained their experience in nursing, their approach is often more patient centered than a physician’s approach. They operate by putting emphasis on keeping patients comfortable and happy as a priority, as opposed to employing a more medical model which is more concerned with making a diagnosis and carrying out a treatment. Nurse practitioners often operate in a more ‘holistic’ way, treating the patient as a whole rather than just the specific symptom or condition. This approach takes more time but means that patients often have a better outlook for the future.
Secondly, the holistic approach that nurse practitioners take is focused on education and prevention. Nurse practitioners will spend a lot of time helping their patients to understand how to make choices to keep themselves healthier. For example, they might help them to understand the benefits of eating healthily and exercising regularly. This work is key in the current physician shortage, as a lot of the chronic diseases that are putting pressure on the healthcare system are preventable, or at least more easily manageable, if people are given the right education and tools to keep themselves healthy.