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Counties across Oregon are suffering from a shortage of primary care Nurse Practitioners (PCNPs), according to a 2019 survey. A recent study from the Oregon Center for Nursing found that despite the promising national statistics reported by the American Association of Nurse Practitioners (AANP), which estimates that over 75% of NPs are practicing in primary care settings, the distribution of these NPs is severely lacking in Oregon.
As PCNPs are vitally needed to compensate for the shortage of physicians, their unavailability is severely felt in parts of Oregon, which is one of the 22 “full practice” states in the US. In contrast to the AANP’s national figures, a state-specific study of Oregon indicates that only one third of practicing NPs (35%) are working in primary care, with another 22% focusing on a combination of specialty and primary care. Of the 22% with combined practices, 62% spend less than half their time on primary care.
Surprisingly, the shortage of primary care NPs tends to be more evident in urban counties, whereas rural counties appear to be better served. Although there are fewer PCNPs by number in rural counties, the proportion of PCNPs is actually higher in rural areas when measured against per capita population figures.
The Oregon Center for Nursing makes three recommendations:
- Communities should promote incentives such as student loan repayment programs and grants to attract PCNPs to practice in their areas. In addition, incentives could be devised to encourage primary care physician groups to hire NPs and include them in their existing practices.
- The education system in Oregon should examine ways to increase the number of PCNP graduates. Currently, some 70% of the PCNPs practicing in Oregon received their degrees in out-of-state schools. This indicates that the facilities within Oregon are not able to meet present needs for the education of PCNPs, and until the state expands educational opportunities for PCNPs, it will be necessary to fill the gap with graduates from other states.
- Community leaders and health officials should explore the reasons that affect NP decisions to focus on primary care. In addition to considering the question of why PCNPs are being drawn more to rural areas in Oregon than urban counties, these officials should ask “Why do NPs choose to work in non-primary care roles? What incentives might change their minds? Once these underlying reasons are understood, communities can use this knowledge to attract NPs to provide primary care in their communities.”
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