With the aging of the baby-boomer population, the present health-care system finds itself at a turning point. Physicians have become over worked due to increasing numbers of patients. Because of this, patients are finding longer wait times in the acute, primary, and specialist care settings. This is not the first time that shortages in physician level care have occurred. In the 1960s the ratio of population growth to medical college graduates was increasing. To address this deficiency some physicians argued for the training of mid-level practitioners. These practitioners were selected from the ranks of nurses and former military corpsmen. Under the supervision and training of doctors these individuals would become the first practicing Nurse Practitioners and Physician’s Assistants (AAPA, 2004; AANP 2010).

In their 2002 article, Cooper, Getzan et al, studied U.S. population projections and were able to find that physician shortages would increase greatly by the year 2020. This will have dramatic effects on the quality and availability of health care. It is fair to assume that patients generally want a provider who is caring, compassionate and well educated. These virtues have always been the ideals of the profession. However, due to the shortage of time, it is almost impossible for a doctor to be caring and compassionate, and also be well informed. According to Cooper and Getzan, “Patients desire the most advanced treatments, but they also seek a caring physician. Ironically, attempts to impede patients’ access to the former have had the unintended consequence of squeezing out the latter.” As more physicians move into specialty areas that require more education in advanced science and technology, there is a need to expand the roles of mid-level practitioners. Due to the time investment needed to become proficient at advance specialties, physicians often lack time to spend with patients.

Currently, physicians assistants and nurse practitioners are an important part of acute, ambulatory and long-term care. They are medical personnel who are suitable to fill the voids in our health-care system. Physicians assistants currently work under physicians, and their scope of practice is defined by the doctor that supervises them (AAPA, 2004). Nurse practitioners are licensed and work individually. Both are trained to assess, diagnose, and treat patients (AANP 2010). According to Hooker and Berlin (2002), “The combined annual number of PA and NP graduates in 2001 was 11,559 — almost a 50 percent increase since 1996.” With the number of medical school graduates in the U.S. staying the same (about 16,000 per year since 2003) (State Health Facts, 2009), PAs and NPs will find themselves taking a greater role in specialty and primary care. Ways to expand their autonomy such as expanding their scope of practice, allowing them to prescribe medications, and making them acceptable practitioners in the eyes of insurance agencies will help reduce the strain on an already over loaded health care system.


Student, University of Massachusetts Lowell