The Contribution of Nurse Practitioners and Physician Assistants to Generalist Care in Underserved Areas of Washington State

Health Services Research

Uses productivity data from the non-physician clinician (NPC) and physician populations in Washington State to assess the contribution to generalist care made by NPCs, giving special attention to the role of NPCs in rural and underserved areas and the role of women NPCs in the female provider population. Overall, generalist NPCs make up 23.4 percent of the generalist provider population and perform about 21 percent of the generalist outpatient visits in Washington State. NPC contribution is higher in rural areas of the state and a bit lower in urban areas. In rural areas, female physicians provided only 49.3 percent of the visits by female providers; female NPCs provided the remaining 50.3 percent. In urban areas, female physicians provided about 63.5 percent; female NPCs provided 46.5 percent. NPCs made similar contributions to total care in rural HPSAs compared to rural non-shortage areas, though physician assistants appear to contribute somewhat more care in HPSAs with severe shortages of providers. The results suggest that accurate and meaningful estimates of available generalist care must take into account the contribution of NPCs.

WWAMI Rural Health Research Center
Eric Larson, Lorella Palazzo, Bobbi Berkowitz, Michael Pirani, Gary Hart