Hospitals, MedCity Influencers

What to expect from nurse practitioners in 2022

Prior to the pandemic, about half of U.S. states had given nurse practitioners full practice authority. Since then, even more states have issued executive orders to allow NPs to take on more responsibility during the pandemic – an emergency response put in place to help address new challenges.

For decades, advocacy groups and professional associations have been pushing states to allow full practice authority for nurse practitioners. That would enable NPs to independently evaluate, diagnose and treat patients.

Prior to the pandemic, about half of U.S. states had given NPs full practice authority. Since then, even more states have issued executive orders to allow NPs to take on more responsibility during the pandemic – an emergency response put in place to help address new challenges.

We know that the pandemic put a massive strain on the healthcare system, pushing many physicians to their limits when there already weren’t enough doctors to meet demand. Additionally, Covid-19 exacerbated health inequities in marginalized communities nationwide, leading to disproportionate mortality rates due to the disease.

With these factors in mind, there is no doubt that the demand for NPs, who are uniquely positioned to improve access to primary care, will continue to increase in the year ahead.

The primary care physician shortage will become more pronounced 

For about two decades, there has been a shortage of primary care physicians in the U.S. – a trend that shows no signs of slowing down for several reasons.

First, fewer medical students are choosing to go into primary care. Additionally, current primary care physicians are retiring at higher rates than ever before, with many choosing early retirement due to burnout caused by the pandemic. It’s a vicious cycle: The mounting pressure on today’s primary care physicians is causing fewer people to enter the profession and more to leave the field. If we continue down this path, the U.S. can expect to see a shortage of about 121,300 primary care physicians by 2030.

While nurse practitioners have long been a critical component of our healthcare system, there is now an immense opportunity for NPs to help curb this primary care shortage and provide patients with improved access to care.

As NPs enter the field, they are choosing to go into primary care more than physicians. In fact, 89% of NPs are certified in primary care, and three times more NPs are graduating in primary care today than physicians.

The spotlight on health disparities will intensify 

The pandemic exposed health inequities that disproportionally affected minority groups. These inequities put minorities at increased risk of getting sick and dying from Covid-19 and further underscore the need for intervention. In the coming months, improving health equity will become an even larger conversation than it is today as increased attention is rightfully focused on reaching patients in underserved communities and remote areas.

But the real challenge for healthcare organizations will be developing and executing a tactical response to address this problem.

Since most physicians choose to practice in metropolitan areas, the shortage is at its worst in rural communities. NPs are ready, able and willing to fill this gap. In addition to being more likely to practice in rural and underserved communities than physicians, NPs comprise a more diverse workforce that better represents their patients. This helps remove specific language and cultural barriers that often prevent people from receiving adequate care.

When discussing equity, it’s also important to recognize that the pandemic expedited the healthcare system’s migration into virtual care, which has greatly improved access. For most patients, this means they can now seek care through their mobile devices via a virtual visit.

Not only does this benefit those in rural and underserved communities who may face transportation issues, it also ensures that vulnerable and elderly populations receive care. As more NPs adopt telehealth themselves and encourage their patients to do the same, telehealth capabilities will only continue to expand.

Full practice authority for NPs will continue to expand

State legislation is broadening the scope of practice for NPs, increasingly allowing them to practice independently. In more than 20 states, NPs already have full practice authority as soon as they earn their license. They have either reduced or restricted practice authority in the remaining states, but this is rapidly changing. For example, in California, NPs are expected to have full practice independence in primary care beginning in 2023.

In addition to more states moving toward full practice authority, the significant Covid-19 exposure risks continue to highlight the need for health plans and government agencies to implement new care models to help provide enhanced care to patients. This includes allowing NPs, who can assess, code, diagnose and prescribe medication just as a physician would, to take on additional responsibility.

As more states continue to widen the scope of license, NPs are naturally stepping into more prominent roles. They’re getting more involved in telehealth programs and in-home solutions in addition to opening their own primary care practices. With this, we can expect to see an increase in resources and tools available to assist NPs in a variety of ways including with business operations.

What’s ahead

It’s clear that NPs are in a prime position to greatly impact our healthcare system this year due to changing legislation, combined with the ongoing physician shortage and widespread movement for health equity.

With all things considered, it will be a significant year for NPs.

Photo: PixelsEffect, Getty Images


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Sylvia Hastanan

Sylvia has spent her career trying to “fix healthcare,” aiming to solve struggling rising costs and uneven quality. With almost two decades of healthcare experience, Sylvia brings to Greater Good Health her talent for marrying clinical and business operations and translating that union into value. With patients and providers always at top of mind, she took on roles to systematically transform the care delivery model for both the payer and the provider. She has a deep understanding of the healthcare system, specifically in managed care and value-based models. As an operator, Sylvia has pioneered medical management programs that address the needs of the highest-risk patients. As a strategist, she has developed innovative initiatives to improve provider burnout, patient experience, evidence-based practice, and leadership development. Sylvia resides in Manhattan Beach, CA with her husband and three daughters.

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