By Jon Parham
In the years ahead, Arkansans may find more of their medical care delivered by someone other than a physician.
The growing shortage of primary care physicians, retirement of baby boomer physicians and increased demand for medical care are factors impacting health care access now and in the future. Growing numbers of nurse practitioners and physician assistants could mitigate these problems.
“Arkansas already has a shortage of primary care physicians and there is no way we can produce enough to meet the needs of our aging population and new patients entering the system because of health care reform,” said Douglas Murphy, Ph.D., dean of the UAMS College of Health Related Professions, which is housing a new physician assistant program under development. “In this environment, these health care providers can contribute much to health care at a very high level.”
The challenge of meeting these needs may also offer the opportunity for improvement through more coordinated team care.
“We don’t want a patient to receive care in bits and pieces in a disjointed manner, depending on what provider the patient sees,” said UAMS College of Nursing Dean Lorraine Frazier, R.N., Ph.D. “All health care professionals are going to have to work together around the patient to provide more seamless care to ensure continuity, efficiency and compatibility of treatment regimens.”
Physician assistants and nurse practitioners can conduct physical exams, order diagnostic tests, write prescriptions, diagnose disease and manage care of patients. Physician assistants work with supervision of a physician. In Arkansas, nurse practitioners need a collaborative agreement with a physician to practice or write prescriptions.
Neither profession is well-known in Arkansas. With a population of 2.9 million, Arkansas ranks 49th in the nation for the number of physician assistants, with about 150. There are just 1,289 nurse practitioners now working in Arkansas.
UAMS hopes to admit its first physician assistant students in summer 2013 for the full-time, 28-month master’s degree program.
Registered nurses and nurses with a bachelor’s degree will likely see increasing opportunities to pursue advanced degrees, said Bill Buron, Ph.D., assistant dean in the College of Nursing. Arkansas has nearly 31,000 registered nurses and almost a third of those have a bachelor’s degree in nursing.
“That means about 9,000 nurses could be mobilized to combine their education and years of health care experience with two to three years of master’s level education to become nurse practitioners in Arkansas,” Buron said. “By comparison, it would take eight years to mobilize a new primary care physician.”
Team care – using the skills of every professional to deliver the best care – will be critical to managing increasing patient volume. Students in many UAMS programs participate in team simulations, learning about their respective roles in patient-centered care and how to communicate with one another.
“Training students how to work as a team while in school improves the quality of care for patients,” said Patricia Kelly, Ph.D., who arrived at UAMS in 2011 to establish and lead the physician assistant program. “It’s about improving the continuity of care, about caring for the patient so that we are treating the patient and not the disease.”
Frazier expects team-based education at UAMS to grow in the years to come. “As a health science center we have an opportunity and a responsibility to make it happen,” she said.