Perspectives of primary care nurse practitioners and physicians

The US healthcare system is at a critical juncture in healthcare workforce planning. The nation has a shortage of primary care physicians. Policy analysts have proposed expanding the supply and scope of practice of nurse practitioners (NPs) to address increased demand for primary care providers. These proposals are controversial. A national postal-mail survey of 505 physicians and 467 NPs in primary care practice was undertaken in 2011-12. The questionnaire included scope of work, practice characteristics, and attitudes about the effects of expanding the role of NPs in primary care. The response rate was 61%. Physicians reported working longer hours, seeing more patients, and earning higher incomes than did NPs. 81% of NPs reported working in a practice with a physician, as compared with 41% of physicians who reported working with an NP. NPs were more likely than physicians to believe that they should lead medical homes, be allowed hospital admitting privileges, and be paid equally for the same clinical services. When asked whether they agreed with the statement that "physicians provide a higher-quality examination and consultation than do NPs during the same type of primary care visit," 66% of physicians agreed and 75% of NPs disagreed.