Advanced Practice Clinicians Slightly More Common in Primary Care, But Specialty Care May Be Catching Up

​Advanced practice clinicians—comprised of nurse practitioners (NPs) and physician assistants (PAs)—are employed by one in four specialty practices and one in three primary care practices, according to a research letter analyzing data from 2008 to 2016 and published in the July 2018 issue of JAMA Internal Medicine. It is not unusual that advanced practice clinicians were employed at a higher rate from 2008 to 2016 by primary care practices, the authors say, because the role of NP was first developed to work in primary care, and most advanced practice clinicians are NPs. The rise of advanced practice clinicians may be driven by the emphasis placed on team-based care, that advanced practice clinicians are less costly overall, and that the number of graduates from advanced practice clinician programs increased during the time period, according to the authors. Overall growth in practices that employed advanced practice clinicians was modest over the eight-year period, according to the research letter, and rates were similar between primary care and specialty practices.