Nearly 60 percent of family physicians work with nurse practitioners (NPs) physician assistants (PAs) or certified nurse midwives (CNMs) to provide a team-based model of care, which will be increasingly important as millions more people in the United States receive health insurance coverage due to the health care reform law.
A new policy brief(www.jabfm.org) co-authored by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care(www.graham-center.org) in the May-June 2013 Journal of the American Board of Family Medicine looks at the trend toward team-based care more carefully.
The brief, which is based on an online survey of 5,818 family physicians in September and October 2011, found that nearly 60 percent of the respondents said yes to the question of whether they "routinely work with nurse practitioners, physician assistants or certified nurse midwives." This question was asked of family physicians accessing their online portfolio on the American Board of Family Medicine (ABFM) website.
"These findings are important because we know our health care system will increasingly rely on teams of health professionals in the patient-centered medical home," said Andrew Bazemore, M.D., M.P.H., director of the Graham Center in a recent press release(www.graham-center.org). "Demand for primary care is growing as our population grows and ages and as more people gain insurance coverage. Earlier research has shown that teams of professionals that include physicians, nurse practitioners and physician assistants can do much to meet demand for care, improve access to care, ensure patients get the full range of medical and nursing care, and have a positive impact on controlling health care costs.”
Lars Peterson, M.D., Ph.D., research director for ABFM and lead author of the study, concurred with Bazemore's assessment, saying in the press release, "Our findings show that family physicians and nurse practitioners, physician assistants and midwives are routinely working together to ensure that patients have access to primary care services. Such teams are even more important in rural areas, which already suffer from a shortage of providers."
The policy brief points out that the nation's physician workforce is struggling to "keep pace with the demand for health care services, a situation that may worsen without efforts to enhance team-based care." The fact that more than half of family physicians work with NPs, PAs or CNMs, means family physicians are helping to "ensure access to health care services, particularly in rural areas," the brief says.
An earlier Graham Center analysis of the primary care workforce found that areas with higher numbers of family physicians, NPs or PAs had lower costs, fewer avoidable hospitalizations and fewer total hospital discharges.
"Teams of family physicians and NPs, PAs and CNMs working together within the patient-centered medical home model are likely essential to meeting the future health needs of all Americans," the policy brief says. "Such teams may help alleviate patient access to health care issues due to the projected shortage of primary care physicians."