Office visits to primary care physicians declined 18 percent

  • Office visits to nurse practitioners (NPs) and physician assistants (PAs) increased 129 percent.
  • Office visits to primary care physicians (PCPs) declined 18 percent from 2012 to 2016 for adults under 65 years old with employer-sponsored health insurance.
  • From 2012 to 2016, office visits to NPs and PAs increased each year.

From 2012 to 2016, office visits to NPs and PAs increased each year. These visits to NPs and PAs may have substituted for some of the visits to primary care physicians, partially offsetting the overall decline in visits to primary care physicians.

However, the total increase in NP and PA visits accounts for just 42% of the total decline in PCP visits between 2012 and 2016.

  • From 2012 to 2016, the rate of decline in PCP visits slowed, while the rate of increase in NP and PA office visits stayed relatively constant.
  • Some visits to NPs and PAs may not have been for primary care, so the 42% offset may be an upper bound.
  • The average cost of an office visit to a PCP ($106 in 2016) was about the same as an office visit to NPs and PAs ($103 in 2016) (Figure 5). Any substitution of providers did not result in cost savings.

Over the last six years I have not seen a PCP when going to my doctor’s office.  I was seen, instead, by a nurse practioner who also prescribed the necessary medications and sent them over to my pharmacy.

Today healthcare, for most people, has become a short office visit in which they are prescribed a medication.  Is it any wonder that minute clinics and quick care medical offices are taking off?   Walgreen’s and CVS are both experimenting with the integration of medical clinics in their retail fronts.

Should this concern doctors?  To a point, yes.  If we all think that our health problems are easily solved with an Rx and a quick visit to a NP, things could get out-of-hand as undiagnosed conditions get worse.  However, let’s be honest…doctors today are forced to see as many patients as possible and don’t have the time they want and need to really get to know patients.

Pharma salespeople have been calling on NP’s for a while now, but are they talking to them in “their language” or are they using the same detail pieces they use for PCP’s?  There is an opportunity here, but only if we customize detail aids for the right audience.

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