Primary Care Physician Shortages Could Be Eliminated Through Use Of Teams, Nonphysicians, And Electronic Communication

Abstract

Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients' ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns. We show that the implementation of some increasingly popular operational changes in the ways clinicians deliver care-including the use of teams or "pods," better information technology and sharing of data, and the use of nonphysicians-have the potential to offset completely the increase in demand for physician services while improving access to care, thereby averting a primary care physician shortage.

Physician, Scribe, and Patient Perspectives on Clinical Scribes in Primary Care

“…3,6,7 Combined with a national shortage of primary care physicians [8][9][10] and increasing physician burnout, 11 these concerns have sparked efforts to redistribute responsibilities in an expanded primary care team. 12,13 In particular, the role of medical assistants (MAs) and nurses have been expanded to include clinical scribing, also known as team documentation. [14][15][16] As clinical scribes, MAs and nurses are hired individually and retain usual duties of gathering information during patient intake, assisting with physician in-baskets, fielding patient phone calls, and performing clinical tasks such as in-office testing and immunizations.…”

Nurse Practitioner Autonomy and Relationships with Leadership Affect Teamwork in Primary Care Practices: a Cross-Sectional Survey

“…Policy makers and researchers are proposing innovative strategies and various workforce utilization models to assure the system is prepared as more people are gaining access. 1,2 While some strategies seek to increase the number of primary care providers (PCPs), 3,4 others seek to encourage efficient use of existing providers. 5 Some policy initiatives, such as medical homes, focus on delivering team-based care to increase primary care capacity and improve patient outcomes.…”

Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs)

“…5,6 However, differences in power and status, as well as a lack of clarity about who should do what, makes delegating tasks a challenge. [7][8][9] Teams struggle with poor role clarity and confusion over responsibility for clinical tasks.…”