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PAs & NPs Make a Real Difference

The US healthcare system is gearing up for its biggest challenge yet: providing quality management of chronic disease to a growing and aging population while having to deal with a shortage of physicians.

Adding to this change is The Affordable Care Act, otherwise known as Obamacare, which helped extend healthcare coverage to approximately 30 million more new people.

In order to meet this ever-growing demand of quality care, physician assistants (PAs) and nurse practitioners (NPs) have come to contribute a substantial amount of primary care and chronic disease management. This is especially prevalent in underserved communities where NPs and PAs often practice with little to no oversight.

While there has been some pushback from certain national physician groups, the reality is that the roles of both NPs and PAs continue to increase, and this reliance on non-physician providers is creating an environment in which they will be compelled to practice to the fullest extent of their education and training.

Because of their advanced training and completion of graduate level degrees, research has indicated that PAs and NPs can provide safe, first-rate care.

Patients Love NPs and PAs

Perhaps most importantly, healthcare consumers (patients) are have become increasingly aware, and accepting, of receiving care from a provider other than a physician.

An article published in Health Affairs during the summer of 2013 revealed that more than 82 percent of patients who had been surveyed were already aware of the concept of NPs and PAs. The authors ultimately concluded that healthcare consumers in the United States are exceedingly open to the idea of being serviced by a physician assistant or nurse practitioner – in many cases preferring it.

In fact, a different study done by the Kaiser Permanente Center for Health Research found that patient satisfaction levels of interpersonal care, confidence in the provider, and understanding of patient problems ranged between 89 to 96 percent for PAs.

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Physicians Aren’t the Only Ones Who Can Provide Quality Care

Another healthcare facet in which NPs and PAs play a vital role is in reducing the morbidity and mortality of chronic disease patients.

For instance, studies have examined the role of PAs and NPs in the treatment of diabetes; one of the most critical chronic diseases that causes substantial expenditures in the US healthcare system.

An article published in MD Edge in 2014 reported on a retrospective study of patients with diabetes seen by over 19,000 physicians, PAs, and NPs who were employed by the VA healthcare system from 2008 to 2012. When the study was concluded, it was revealed that the characteristics, comorbidity levels, and HBA1c levels of patients were similar, regardless if a physician, NP, or PA had treated them.

Some studies have even suggested that diabetic patients seen by NPs or PAs are more stable and less insulin dependent.

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Another study published by the American Heart Association in 2015 found that overall cardiovascular disease care quality between physicians, PAs, and NPs did not differ.

Over a one-year span, one million patients were evaluated for three measures of CV care: blood pressure of <140/90, receiving a beta blocker, and receiving a statin. While blood pressure control was achieved more readily by PAs and PAs, beta-blockers and statins were achieved more by physician. Overall however, 54 percent of those receiving care from physicians and 54.8 percent of those receiving care from PAs and NPs met all three measures.

NPs and PAs Have a Positive Effect on Patient Experience

Despite their lower salaries, NPs and PAs are able to perform the vast majority of tasks that a physician does. Their similar skill set means they can: perform physical exams, write prescriptions and order diagnostic tests, diagnose and treat conditions such as diabetes, and can help in educating patients on health and lifestyle choices.

A survey released on Medscape indicated that while only 50 percent of patients reported they felt doctors “always” listened carefully, more than 80 percent of patients felt that their NP paid great attention to their needs.

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