The Role of Mid-level Providers

Health care has encountered a situation where the demand for our services is greater than the supply of physicians. In the very near future, the shortage of physicians will become even greater. At the time of writing this book, primary care physicians are already in short supply. The American Academy of Family Physicians predicts a shortfall of 40,000 primary care physicians by 2020. Moreover, the US Bureau of Health Professions projects a shortage of 109,600 physicians in all specialties by 2020. One thing is certain – following the passage of the Affordable Care Act (Obama Care), 32 million additional Americans are going to have health insurance, and someone will need to take care of them. Who will provide medical care to millions of newly insured people? Upon passage of the Affordable Care Act, physician practices were overwhelmed by the increased demand. Many doctors stopped taking new patients; the concept of concierge medicine, also called direct primary care, has decreased the availability of primary care physicians, and those physicians who continue to accept new patients have seen waiting times for appointments lengthen significantly. Visits to emergency rooms have increased by 7%, adding unanticipated costs to the program. To resolve this situation, physician practices and hospitals must proactively add capacity to treat large numbers of new patients. This chapter will identify mid-level providers and describe the role they can assume to increase the care we want to provide our patients.