ccording to a recent MGMA-ACMPE study (reported in the journal AAFP) over the last 11 years, the cost of running a medical practice in the United States has increased twice as quickly as the consumer price index. This surprising and dramatic gap underscores the significant financial challenges facing many primary care providers, including revenue streams that may fail to counter the rising costs of keeping a practice afloat.
Small practices, with a limited number of physicians and resources that can only be stretched so thin, are perhaps hit hardest.
As an aging baby boomer population and Affordable Care Act legislation introduce a large pool of newly insured patients needing care, there is a shortage of primary care physicians to serve them -- a deficit that will continue to grow. In fact, the American Association of Medical Colleges found that the deficit of general practitioners was around 9,000 in 2010 and estimates it will increase to 29,800 by 2015 and 65,800 by 2025.
The environment created by these factors points to an uncertain future for small general medicine practices unless they can find ways to cut costs without compromising the quality of care. One way that small practices can make significant strides in meeting these challenges is through the addition of nurse practitioner (NP) staff with a diverse skillset.
As a nurse practitioner myself, I have witnessed first-hand the ways that my colleagues and I can help improve not only the cost, but the quality of primary care, as we work closely alongside physicians to meet patient needs. Our rigorous medical education and training ensures that we are able to perform many of the same tasks as doctors. With an NP performing basic diagnostic and treatment needs, more practices are realizing an ability to increase the number of patients that can be seen each day. Meanwhile, NPs typically require less compensation than physicians, further offering a cost benefit.
NPs can also help lead some practices’ efforts to bring more specialty services to the primary care setting. While working with a group of clinicians with a wide range of specialties has historically been a benefit reserved for those working in large health systems, smaller primary care practices can also expand the range of expertise in their offices by bringing on NPs with different specialties. These additions enhance the services offered, increase marketability, introduce new revenue streams and ultimately help practices better serve patients.
This is a trend in healthcare that, as an NP, I have gladly become a part of. For example, in practices that offer allergy testing and immunotherapy via providers such as United Allergy Services, NPs can deliver these offerings, boosting practice efficiency as well as patient access to much-needed care services.
Immunotherapy treats the chronic condition of allergies instead of just masking the symptoms. With not only physicians, but also NPs in primary care practices trained to deliver these services, providers can give more patients who suffer from allergies access to a comprehensive, preventive therapy that was once only available through specialized allergists.
In today’s ever-changing healthcare landscape, skilled NPs will continue to be part of the solution to many care and cost challenges. This is especially true when it comes to small primary care practices, where the addition of just one highly skilled nurse practitioner can greatly increase efficiency, income and even patient satisfaction, providing a buffer for rising operating costs and potentially making what may have been an uncertain future a bit brighter.
By Kevin Letz
September 4, 2013