OGDEN -- Hospitals and clinics are turning to a wider range of medical professionals to help combat a growing workload.
With an anticipated shortage of primary-care doctors and an increase in demand for medical services by aging baby boomers and people who will be newly insured through health-care reform, nurse practitioners and physician assistants are carrying heavier loads of patients to help meet the demands.
Dr. Grace O'Brien, a family physician at Ogden Clinic, said she uses both NPs and PAs in her practice. She said they give the clinic more accessibility to her ever increasing practice.
"We only have so many available appointment slots during the day, especially during the busy winter season with colds and flu, so we work as a team," she said. "If I am booked, they are willing to see my patients. When they are full, I will see their patients."
O'Brien said although NPs and PAs care for and make the full medical decisions on their patients, they still have her review a percentage of their charts. As the supervising physician, she is aware of the care that is provided.
"They are very helpful to assist in running a busy family practice. Patients adore them because they are caring and sometimes provide a little more time teaching and educating patients," she said. "Family practice doctors seems to be a dying breed because we are the lower end of the pay scale. With the high medical school debt that a lot of physicians acquire, they are selecting higher-paying fields."
Cindie Dodenbier and Roxina M. Fischer are certified nurse practitioners at O'Brien's office. Fischer deals mostly with family care, while Dodenbier deals mostly with pain management.
"There is a shortage of people trained in some of these specialties, such as pain management," Dodenbier said. "... Not only do we see our own patients, but we diagnose, treat, prescribe medicine, order tests and follow up with patients."
Dodenbier said these advanced-practice professionals are incorporated in virtually every aspect of medicine, from family practice to orthopedics and obstetrics.
Fischer said there is a definite trend in the utilization of NPs and PAs in both office and hospital settings. She said more people are being trained to provide high levels of expertise, including treating complicated illnesses.
"I see people from newborn to geriatric ages. I manage short- and long-term illnesses, medications, therapies and needs," she said.
Both professions require a minimum of a master's degree. According to the American Academy of Nurse Practitioners, the average yearly salary is $94,050.
Physician assistants earn approximately $87,000 to $100,000, according to the U.S. Bureau of Labor Statistics.
Richard Ray Russell is a PA for Intermountain Healthcare. He said his job has changed significantly over the years.
"I was seeing scheduled patients in a rural clinic and making house calls. Now I work in a busy urban insta-care," he said. "At times, it seems like an extension of an emergency room in the type of sick patients that we see."
Russell said he believes there is an added measure of care and concern for each patient seen by NPs and PAs.
"I have had some patients comment that we take more time to answer questions and really listen to the patient's concerns and needs," he said.
Dr. Abdul AbuQare, medical director of the hospitalist program at Davis Hospital and Medical Center, said the shortage in primary care and family practice in the outpatient and hospital setting is a nationwide issue that has been looked at with concern.
"It continues to be an issue with time because as population, age and life expectancy increase, there will always be a demand for their services," he said. "I believe the lack of proper education on the role of primary care, the compensation system and health care model has played a significant (role in) this issue."
AbuQare said NPs and PAs have helped in dealing with these obstacles.
Brandon Jones, a PA at Davis Hospital, said he diagnoses, interprets lab results and other diagnostic studies/tests, prescribes medications and recommends treatment options for his patients.
"I think patients often relate to PAs and NPs in a way that makes them more comfortable to ask questions about their health and the care they are receiving," he said.
Cindy Dean is hospitalist program director for Ogden Regional Medical Center, Lakeview Hospital and Brigham City Community Hospital.
She said NPs are used frequently in the hospitals because of their nursing experience.
"NPs are typically RNs who have worked in a hospital setting for many years and then furthered their education to become an NP," she said.
"They already have experience in the ICU, medical and surgical departments. They bring expertise and advanced education to the job, both of which are critical to working with hospitalists and caring for hospitalized patients."
Dean said in hospitals across the country, the realization has grown that patients are better served when there is a physician onsite and available to admit them when necessary.
This has created a huge demand for hospitalists, which is not met by the number available. NPs have helped to fill this gap, she said.