Tipping Point Ahead

Prepared for a New Primary Care?
Sep 01, 2006
By Pharmaceutical Executive Editors

According to the American College of Physicians, recent years have seen a significant drop off in the number of doctors entering primary care practices. US medical-school surveys found that in 1998 more than half of all third-year residents intended to pursue general medicine. By 2005, the number had dropped to one in five. As clinical demand increases, nurse practitioners (NPs) and physician assistants (PAs) are practicing with greater autonomy and prescribing more medication than ever before—approximately 750 million prescriptions per year. NPs and PAs represent a major component of our present and future healthcare delivery system, yet historically the pharmaceutical industry has considered them secondary targets.

Demand for NPs and PAs
In order to provide effective educational opportunities and product information to this rapidly evolving medical community, pharmaceutical companies must expand their awareness, with a two-fold approach that includes promotional and educational initiatives.

Promotionally, the pharmaceutical industry should encourage its reps to spend as much face time with NPs and PAs as they currently do with physicians. These clinicians typically spend more time than most physicians counseling and educating patients, so if they are armed with accurate drug information, it can lead to increased compliance and better outcomes.

Pharma companies have a responsibility to develop and provide targeted continuing medical education (CME)/continuing education (CE) for NPs and PAs. Until recently, there have been no significant national CME/CE programs focused on this group. But now an increasing number of independently produced, multi-supported symposia (such as the Practicing Clinicians Exchange, launched in 2005) cater exclusively to the specific educational needs and goals of NPs and PAs.

This healthcare tipping point is evidence based. The American Medical Association (AMA), the American College of Physicians, the Robert Graham Center, and the US Department of Labor all cite a shortage of primary care physicians, and some predict the problem is only going to get worse:

  • Challenged by the first wave of 78 million baby-boomers turning 60 this year, the AMA announced that there is, "a shortage of physicians, at least in some regions and specialties, and that evidence exists for additional shortages in the future."
  • The Robert Graham Center warns that, "a persistent, six-year trend in the choice of specialty training by US medical students threatens the adequacy of the physician workforce."
  • The US Department of Labor ranks PAs as one of the fastest growing occupations through the year 2014, and projects that patients will be relying more on other healthcare providers.

The confluence of changing demographics within the medical profession and increasing consumer demand for healthcare services has brought our nation's primary-care system to a tipping point. Market forces continue to move primary care physicians away from patients, and draw NPs and PAs toward patients in response.

Within the next few years, NPs and PAs will become first-line medical professionals for our country's growing and aging population. In order to ensure a robust healthcare future for our nation, the pharmaceutical industry should lead the charge to recognize these increasingly important clinicians with formalized, targeted educational initiatives. The industry must provide the leadership needed to support this crucial educational goal and to adapt continuing education to our evolving healthcare system. If pharma does not step up, who will?

Brad Mock and Nick Kiratsous contributed to this article.

Robert Green
is managing director at Continuing Education Alliance. Sally Bacchetta is a contributing writer for the company.

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