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Physician, NP, and PA Growth Has Significantly Outpaced Population Growth

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Theo Merkel
Director Private Health Reform InitiativeatParagon Health Institute

Theo Merkel is the Director of the Private Health Reform Initiative and a Senior Research Fellow for the Paragon Institute and a Senior Fellow at the Manhattan Institute.

Bill Finerfrock

Drew Gonshorowski
Senior Research FellowatParagon Health Institute

Drew Gonshorowski is a Senior Research Fellow at Paragon Health Institute. He brings a decade of experience conducting quantitative research and building models examining health policy and entitlement programs.

This week’s Paragon Pic shows, contrary to popular belief, that the United States has more physicians per 10,000 people today than it has ever had. In addition, U.S. patients now have the benefit of the nearly 600,000 currently practicing nurse practitioners (NPs) and physician assistants (PAs). Overall, the number of these health professionals per 10,000 people more than doubled between 1980 and 2020—from 21.4 per 10,000 to 44.4 per 10,000. Roughly 43.6% of that increase was from the growth in physicians and about 56.4% of that increase was from the growth of NPs and PAs, two classes of professionals that were largely nonexistent in 1980.

This figure was adopted from Paragon’s paper, “Where are Provider Shortages? Reassessing Outdated Methodologies,” authored by Bill Finerfrock, an expert on rural health issues. In the paper, Bill discusses how the current way that the federal government defines health provider shortage areas is based on the 1970s workforce. It fails to include NPs and PAs in the methodology for evaluating shortages even though they have rapidly grown in number since then. Bill recommends several changes to the methodology, including the incorporation of NPs and PAs in the provider-to-population ratio so that federal resources would be better directed to areas of the country where there are actually provider shortages.

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