Few nurse practitioners, physician assistants pursue careers in pediatric health

Oct 18, 2010

Pediatric health care work force planning efforts are increasingly incorporating the roles of nurse practitioners and physician assistants, especially in plans to alleviate the perceived shortage of pediatric subspecialists.

However, results from four new studies of pediatric nurse practitioners, family nurse practitioners, neonatal nurse practitioners, and pediatric physician assistants published online today in the journal Pediatrics do not seem to support that idea. The work was conducted by the University of Michigan's Child Health Evaluation and Research (CHEAR) Unit, led by Gary Freed, M.D., M.P.H., chief of the Division of General Pediatrics and director of the CHEAR Unit.

"Although there are overall increases among those professionals, there has been no increase in the number of nurse practitioners and physician assistants going into pediatric ," Freed says. "Newly trained professionals in those jobs will likely decrease going forward as more health care systems are designed to take care of the elderly population. Health systems need to re-think many of their future plans."

Study findings:

  • A study looking at the roles and scope of practice of pediatric nurse practitioners found that the majority currently works in primary care and most do not have any inpatient roles. Independent pediatric nurse practitioner practices are not responsible for a significant portion of pediatric visits. Pediatric nurse practitioners are unlikely to alleviate the currently perceived shortage of pediatric subspecialists without a significant change in the pediatric nurse practitioner workforce distribution.
  • A study looking at the roles and scope of practice of family nurse practitioners in the care of pediatric patients found that among family nurse practitioners who care for children, pediatric patients represent only a small fraction of their patient populations. Family nurse practitioners are unlikely to have a significant impact on the availability of either primary or subspecialty care for children in the future.
  • A study looking at the roles and scope of practice of physicians assistants found that they can and do play an important role in the care of children in the United States. However, fewer than 3% are engaged in nonsurgical pediatric primary or subspecialty care. Thus, their role is limited by the relative scarcity of physician assistants currently engaged in pediatric practice.
  • A study of the roles and scope of practice of neonatal nurse practitioners found discrepancies in their distribution across the country, which may impact care provision in NICUs in certain regions. Comprehensive studies that examine the demand for neonatal nurse practitioners and the roles of other clinicians in the NICU should provide a greater understanding of appropriate NICU workforce capacity and needs.
"This is a wake-up call," Freed says. "No one bothered to check whether or not there are more nurse practitioners and physician assistants available to provide care to children. Health care planners are making assumptions about a workforce that may not exist to the extent of their projections."

"Children are becoming a smaller and smaller proportion of the U.S. population. We must ensure that as our society ages, we have a sufficient medical workforce at all levels to address health care needs."

Explore further: Exploring 3-D printing to make organs for transplants

More information: References:

"Family Nurse Practitioners: Roles and Scope of Practice in the Care of Pediatric Patients," Gary L. Freed, MD, MPH, Kelly M. Dunham, MPP, Carol Loveland-Cherry, PhD, RN,d and Kristy K. Martyn, PhD, FNP-BC, CPNP-PC, all of the University of Michigan, and the Research Advisory Committee of the American Board of Pediatrics. doi:10.1542/peds.2010-2157

"Pediatric Physicians Assistants: Roles and Scope of Practice," Gary L. Freed, MD, MPH, Kelly M. Dunham, MPP, Marc J. Moote, MS, PA-C, Kara E. Lamarand, MPH, all of the University of Michigan and the American Board of Pediatrics Research Advisory Committee. doi:10.1542/peds.2010-1586

Pediatric Nurse Practitioners: Roles and Scope of Practice, Gary L. Freed, MD, MPH, Kelly M. Dunham, MPP, Kara E. Lamarand, MPH, Carol Loveland-Cherry, PhD, RN, Kristy K. Martyn, PhD, FNP-BC, CPNP-PC, all of the University of Michigan, and the American Board of Pediatrics Research Advisory Committee. doi:10.1542/peds.2010-1589

"Neonatal Nurse Practitioners: Roles and Scope of Practice," Gary L. Freed, MD, MPH, Kelly M. Dunham, MPP, Kara E. Lamarand, MPH, Carol Loveland-Cherry, PhD, RN, and Kristy K. Martyn, PhD, FNP-BC, CPNP-PC, all of the University of Michigan, the Research Advisory. doi:10.1542/peds.2010-1596

add to favorites email to friend print save as pdf

Related Stories

Evolving roles difficult for GPs but good for patients

Jun 13, 2008

The solutions to Australia's general practitioner shortage are not just in increasing GP numbers, but in developing new roles to care for patients, according to research published by the Australian Primary Health Care Research ...

Doctor shortage? 28 states may expand nurses' role

Apr 13, 2010

(AP) -- A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want ...

Guided Care participants rate quality of health care high

Jan 19, 2010

Chronically ill older adults who are closely supported by a nurse-physician primary care team are twice as likely to rate their health care as high-quality than those who receive usual care, according to a study by researchers ...

Recommended for you

Exploring 3-D printing to make organs for transplants

Jul 30, 2014

Printing whole new organs for transplants sounds like something out of a sci-fi movie, but the real-life budding technology could one day make actual kidneys, livers, hearts and other organs for patients ...

High frequency of potential entrapment gaps in hospital beds

Jul 30, 2014

A survey of beds within a large teaching hospital in Ireland has shown than many of them did not comply with dimensional standards put in place to minimise the risk of entrapment. The report, published online in the journal ...

Key element of CPR missing from guidelines

Jul 29, 2014

Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

Burnout impacts transplant surgeons (w/ Video)

Jul 28, 2014

Despite saving thousands of lives yearly, nearly half of organ transplant surgeons report a low sense of personal accomplishment and 40% feel emotionally exhausted, according to a new national study on transplant surgeon ...

User comments : 0