Advanced Practice Professionals in Today’s Medical Practice

by Sheri Sorrell and Keith Jennings, July 8, 2014

It's a good time to be an advanced practice professional.

Job satisfaction is high. Demand is strong. And physicians, especially those who use them, are satisfied with the productivity and skillset advanced practitioners bring to their medical practice.

A key trend we've tracked since 2012 is how physicians are using nurse practitioners, physician assistants and other advanced practice professionals (APPs) in their medical practice. And how these choices are impacting physicians' attitudes and productivity.

In this article, we will share our key findings related to APPs from this year's national physician survey.

Use of Physician Assistants on the Rise

When asked about their use of APPs, physicians reported the following:

  • 44 percent do not use APPs
  • 35 percent use nurse practitioners (NPs)
  • 30 percent use physician assistants (PAs)
  • 10 percent use certified registered nurse anesthetists (CRNAs)

When asked how their use of APPs has changed in the last year, 66 percent reported it has remained unchanged. However, 30 percent said their use of APPs had increased. Only four percent said it had decreased.

Although use of NPs has remained steady between 2012 and 2014, the use of PAs has shown a statistically significant increase. Twenty-five percent of survey respondents in 2012 reported using PAs. This rose to 30 percent in 2014.

Hospital-based specialties like critical care medicine, emergency medicine and hospitalists, as well as surgical subspecialists are most likely to use physician assistants. Hospital-based specialties and pediatricians are most likely to use nurse practitioners. And behavioral health specialists are most likely not to use advanced practice professionals.

Physician Preference Split Between NPs and PAs

When asked which APP they would rather work with, if they had a choice, physicians were split between PAs (31 percent) and NPs (30 percent).

Pediatricians and women's health specialists were most likely to prefer working with NPs. Surgical subspecialists, general surgeons and hospital-based specialists were most likely to prefer working with PAs.

APPs Positively Impact Medical Practices

Seventy-six percent of physicians said APPs contribute to the productivity of physicians and their medical practice. They said more patients receive care when APPs are part of their practice team. Only twenty-four percent reported no change in the number of patients treated.

Sixty-one percent of physicians reported that duties formerly performed by physicians being taking on by APPs. And 60 percent affirmed that this is a positive trend, especially surgery subspecialists, general surgeons and internal medicine subspecialists. Anesthesiologists were more likely to view this as a negative trend.

The Attitudes & Outlook of APPs

In 2012, 74 percent of the NPs and Pas we surveyed were satisfied or very satisfied with their current work environment.

At the time of that survey, both NPs and PAs reported seeing an average of 16 to 18 patients per day, but said that number was increasing as they were asked to take on more responsibility.

Forty-seven percent of respondents foresaw risks to the NP role and 32 percent anticipated risks to the PA role. That said, APPs saw the NP role evolving to assume more responsibility in patient care, especially primary care. And PAs will continue to specialize with demand for their services expected to increase.

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Survey Methodology

A total of 1,527 physicians completed this survey, which was conducted between April 18 and June 5, 2014. The error range for this survey was +/- 2.5 percent at a 95 percent confidence level.

Invitations for Jackson Healthcare's surveys are emailed to subsets of a database, which include physicians who have been placed by Jackson Healthcare's staffing companies and those who have not.

Respondents to all surveys were self-selected and spanned all 50 states and medical/surgical specialties.

About the Authors

Sheri Sorrell leads Jackson Healthcare's market research efforts. Keith Jennings is the company's marketing and content strategy director.