NPs, PAs avoiding primary care, while docs glum about independent practices

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The hope that nurse practitioners and physicians assistants could help ease the pressure on general practitioners appears to have dimmed. Research published in American Family Physician on August 15 indicates that these healthcare professionals are gravitating toward sub-specialties, instead of general practices.

Researchers write that the flow of NPs and PAs into fields other than general practice is a surprise because of poor assumptions: they say that the common thought had long been that these professionals who were not affiliated with a physician were “assumed to be in primary care,” but that data from the American Academy of Physician Assistants and a 2008 survey of registered nurses finds that this assumption has overestimated just how many of the professionals have gone into the primary care field. This is despite incentives such as debt reduction for pursuing this route.

Meanwhile, an Athenahealth/ePocrates survey shows why small practices, both specialty and general HCPs, may be failing to capture the attention of NPs and PAs: 65% of independent docs said they felt the healthcare climate was such that quality of care was going to decline over the next five years, while 55% of what Athenahealth and ePocrates called “employed” physicians felt the same way.

Their views on financial outcomes also followed a downward curve, with 36% of MDs saying they expected their financial situation to be worse than last year's, whereas 34% felt this way in 2012. This last point feeds into the next, which is that 78% of the polled physicians said they had little hope independent practices have a future. This is 3% more optimistic than 2012, though, when 81% of the polled physicians said they felt that way, but still points to a significant majority.

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