Doctor Shortage: Short Doctors

This article (1) is not about short doctors under 5’10”, it’s about a shortage of primary care physicians (PCP). Sources indicate:

“The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply, according to new data published today by the AAMC (Association of American Medical Colleges). The projected shortfall is similar to past projections and ranges from 46,900 to 121,900 physicians.”(2)

The article then goes on about talking points about how Advance Practice Registered Nurses (APRNs) can replace PCPs to fill this shortage. The article professes APRNs as medical professionals, who have at least a master’s degree and have worked as registered nurses, and are formally trained to provide much of the same care that a standard doctor does. The inference is that APRN’s practice medicine like doctors practice medicine. As a former APRN now MD, I counter this notion in that one discipline cannot fill the gap of a different discipline. However, talking points such as those in the article where it states: “Studies have shown that receiving medical care from an APRN results in equal (or sometimes better) outcomes for patients.”This statement is not cited with references and has been refuted in prior blogs I have written about (3,4). In fact, studies show the opposite (3-5). 

The article also reports:

“…. asks naysayers which health professional is more likely to move to a rural county and fulfill the major healthcare needs of a small community: a doctor who can find plenty of high-paying work in urban areas, or an APRN whose nursing background involves more hands-on time with patients and less student loan debt?”

            This notion of increasing APRN practice in rural areas has also been refuted in a prior blog I wrote about. The argument is that full practice authority is needed in order to increase access to primary care in rural areas. This turns out to be a straw man argument (6). Nothing more than a talking point. I am pro-APRN on physician lead teams and am pro-truth. Truth is, studies referenced in articles such as this are rarely cited and if cited, the studies can be refuted on poor methodology and/or skewed/biased data (7). So when it comes to the impending doctor shortage, it’s my belief that the gap should be filled with short doctors, tall doctors, fat doctors, skinny doctors, male doctors, female doctors, DO doctors, and MD doctors. Replacing one discipline with those in the same discipline. It is inappropriate to fill the gap with another discipline. 

REFERENCES: 

  1. https://www.nevadacurrent.com/2019/07/26/nurse-practitioners-are-one-part-of-solution-to-nvs-doctor-shortage/
  2. https://news.aamc.org/press-releases/article/2019-workforce-projections-update/
  3. https://authenticmedicine.com/forget-the-beef-knock-off-meat-substitute-is-worse-than-no-beef-an-expose-on-aanp-position-statement-quality-of-nurse-practitioner-practice/
  4. https://authenticmedicine.com/wheres-the-beef-part-1-a-critique-one-study-at-a-time-on-nurse-practitioner-full-practice-authority-model-vs-physician-supervision-collaboration-model/
  5. Lohr, Robert H. et al. (2013) Comparison of the Quality of Patient Referrals From Physicians, Physician Assistants, and Nurse Practitioners.” Mayo Clinic Proceedings , Volume 88 , Issue 11 , 1266 – 1271
  6. https://authenticmedicine.com/straw-man-the-dishonesty-needs-to-stop/
  7. https://authenticmedicine.com/a-take-on-evidence-based-medicine-a-biased-report/

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