A Physician-Led Approach for Integrating NPs and PAs into High-Quality Care
There is a recognized physician shortage across the United States – a situation that has only been exacerbated by post-pandemic attrition, broad economic challenges, Medicare reimbursement issues, and more. Even if there were enough physicians, their geographic distribution would likely not match patient demand.
The combination of these factors creates the current reality for patients in our health care system – one that can leave far too many without timely access to the care they need.
The reality of poor access to health care should not be the patient’s burden to carry, nor should we compromise quality expectations in our pursuit of timely and sustainable access to care.
In order to provide access to care wherever patients need us, collaborative models of care must be part of the solution. These models must support safe, high-quality care by physician-led teams. They must include thoughtful application of prior training, education, and experience. And the models must deliver the high-quality outcomes patients need.
Historically, the utilization of NPs and PAs has faced challenges. While the challenges vary, they often relate to perception, especially among physicians, who play the central role in care delivery. Attitudes vary widely, from those reluctant to involve NPs and PAs in critical tasks and decision-making, to others who- in contrast - believe these professionals can and should assume more responsibility in various situations.
However, when NPs and PAs experience effective collaboration with physicians, and their clinical expectations are matched with training and experience, the care delivery model can be positively impacted.
It’s crucial to approach questions about NP and PA quality from a data-driven perspective. Instances of undesirable care or poor outcomes stem not from inherent limitations of NPs and PAs, but from models or practical experiences that lack communication and collaboration or deploy a mismatch of clinical demands with skills, experience, and training.
Over the past two decades, considerable research has shed light on the performance of NPs and PAs compared to physicians. Studies have examined various aspects of care, including quality metrics and resource utilization across different health care settings. While results can vary depending on the context and patient population, a significant body of evidence suggests that NPs and PAs can deliver safe, effective, high-quality care, particularly for less complex conditions.
This is supported by recent data. As one example, SCP Health's analysis of a year’s worth of Merit-Based Incentive Payment System (MIPS) data from approximately 1,200 PAs and NPs and 3,000 physicians in 267 hospital settings across 24 states showed that NPs and PAs achieved quality scores that were not only similar to those of physicians in both emergency and hospital medicine settings, but were also outstanding with average quality measure compliance over 98%.
This aligns with broader industry findings that demonstrate the valuable contributions of NPs and PAs in enhancing patient care and satisfaction, particularly in areas such as reducing emergency department wait times, improving patient satisfaction, and managing certain medical complaints.
These results do not suggest that NPs and PAs can replace physicians. Rather they highlight the potential for these professionals to complement and expand the capacity of physician-led care when integrated into highly collaborative health care teams.
Ultimately, the economics of care delivery require an approach where NP and PA engagement is appropriately matched to clinical demand and supported with the right education and training. When this is done effectively, safe clinical care is delivered, and successful quality results follow.
Moving forward, success hinges on our ability to work together. The challenges facing health care are too complex for any one group to solve alone. By breaking down silos and fostering genuine collaboration among all health care professionals—physicians, NPs, PAs, and others—we can create a more resilient and effective health care system.
Download the whitepaper, “Optimizing Quality and Cost: The evolving role of NPs and PAs,” for more data insights on this topic, as well as suggested training and education programs to support clinical excellence.