With the Affordable Care Act (ACA) adding millions of newly insured patients, along with the large numbers of aging baby boomers, physicians are being asked to do more than ever. To help alleviate this overwhelming demand for physicians some of the traditional responsibilities of doctors are now being given to nurses, nurse practitioners, physician assistants, and pharmacists. How are physician extenders helping to bring relief to our overloaded healthcare system?

What Are Physician Extenders?

Physician extenders are “healthcare professionals with advanced degrees and medical training to assist” physicians in providing medical care to patients.1 They include physician assistants, nurse practitioners, nurses, and pharmacists. They are supervised by physicians in hospitals or medical facility settings. Based on their training, their duties include diagnosis, writing treatment plans and prescriptions, and ordering tests.

Offset Physician Shortage

With the shortage of physicians expected to reach 20,400 by 20202, the use of physician extenders can relieve some the patient care burden being placed on physicians. Extenders treat minor illnesses and injuries that congest ERs and take up time medical doctors could be devoting to more urgent patient matters. Multidisciplinary staffing models have also seen an integration of nurse practitioners and physician assistants in the ICU and other acute settings.3

Projections have shown that the number of primary care nurse practitioners (NPs) will increase by 30% in 2020 (from 55,400 in 2010 to 72,100 in 2020). 4 Primary care physician assistants (PAs) are projected to “increase by 58 percent, from 27,700 to 43,900 over the same period.” 4 With such large growth, it is estimated the shortage of primary care physicians will go from 20,400 to 6,400 in 2020 if extenders are utilized. 4

Benefits of Physician Extenders

Hiring physician extenders can improve the bottom line for healthcare facilities of all sizes. The savings come in the form of lower salaries, reduced overhead costs, lower care costs, higher patient volumes, and lower insurance and liability costs.7 And these cost savings occur without lowering patient satisfaction. According to a Berkeley HealthCare Forum report, “highly trained nurses, such as NPs, clinical nurse specialists, or advanced practice nurses provided comparable or higher quality care and had comparable patient satisfaction and health outcomes as physicians.”8

Acceptance of Extenders

The American Association of Nurse Practitioners and the PwC Health Research Institute conducted a survey of patients in the US to assess their level of comfort seeing a physician extender. The summary concluded that: “Three-quarters of consumers say they would be comfortable seeing a nurse practitioner or physician assistant for physicals, prescriptions, the treatment of minor injuries and ordering lab tests…Half would be comfortable going to a pharmacist instead of a doctor for some services.” 7

Over one-third of doctors surveyed stated they would like to use physician extenders for more than half of their patients so they can spend more time with patients, have better care coordination, and enjoy a healthier work-life balance. Conversely, some doctors are not as willing to hand over their patients to extenders, citing they don’t believe NPs or PAs have enough medical training to properly diagnose patients. 9


Expanded duties for physician extenders means changes in credentialing requirements. For instance, according to The Joint Commission standard HR.01.02.05, PAs and advanced practice registered nurses (APRN) who practice within the hospital can be credentialed, privileged, and re-privileged through the medical staff process or an equivalent process, while APRNs who are licensed independent practitioners (LIPs) are credentialed and privileged only through the medical staff credentialing and privileging process. Further, the Centers for Medicaid and Medicare Services (CMS) requires that all “non-physicians, including physician assistants and certified nurse practitioners, who are granted privileges at a facility be subject to the medical staff requirements and the conditions of participation.”10

By utilizing extenders, facilities can provide care to more patients, while taking some of the strain off overworked physicians and doctors. Now may be the time to expand your use of physician extenders of all types. With IntelliCentrics , healthcare facilities do not have to worry about the increased credentialing volume. The system provides primary-sourced credentials for all levels of practitioners, freeing your medical staff office for onboarding and privileging activities. Let us handle the increased volume and manage credential changes while providing a shortened time to revenue.


  1. http://www.newyorkpresbyterianhospital.com/advances/physician-extenders.html
  2. http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/primarycare/index.html
  3. http://www.hpnonline.com/dailyupdates/May_15-2.html#4-4
  4. http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/primarycare/index.html
  5. http://www.pharmacytimes.com/publications/directions-in-pharmacy/2014/december2014/A-Health-System-Perspective-The-Evolution-of-the-Pharmacists-Role
  6. http://www.ashpintersections.org/2014/01/growing-trend-toward-specialization-board-certification-2/
  7. http://profitable-practice.softwareadvice.com/nurse-practitioners-and-physician-assistants-why-you-should-hire-one-or-the-other-0513/
  8. http://berkeleyhealthcareforum.berkeley.edu/wp-content/uploads/Appendix-IX.-Nurse-Practitioners-and-Physician-Assistants-Initiative-Memorandum.pdf
  9. http://www.pwc.com/en_US/us/health-industries/top-health-industry-issues/assets/pwc-hri-top-healthcare-issues-2015.pdf
  10. http://www.wphealthcarenews.com/pennsylvania-senate-bill-proposes-independent-practice-of-certified-nurse-practitioners/

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