title: Specialty distribution of physician assistants and nurse practitioners in North Carolina.
abstract: Physician workforce projections often include scenarios that forecast physician shortages under different assumptions about the deployment of physician assistants (PAs) and nurse practitioners (NPs). These scenarios generally assume that PAs and NPs are an interchangeable resource and that their specialty distributions do not change over time. This study investigated changes in PA and NP specialty distribution in North Carolina between 1997 and 2013. The data show that over the study period, PAs and NPs practiced in a wide range of specialties, but each profession had a specific pattern. The proportion of PAs-but not NPs-reporting practice in primary care dropped significantly. PAs were more likely than NPs to report practice in urgent care, emergency medicine, and surgical subspecialties. Physician workforce models need to account for the different and changing specialization trends of NPs and PAs.
authors.affiliation: Erin P. Fraher is an assistant professor in the departments of family medicine and surgery at the University of North Carolina at Chapel Hill's School of Medicine. Perri Morgan is a professor in the Department of Community and Family Medicine at Duke University School of Medicine in Durham, N.C. Anna Johnson is a consultant in the Department of Epidemiology at the University of North Carolina at Chapel Hill. The authors have disclosed no potential conflicts of interest, financial or otherwise.
authors.forename: Erin P
authors.initials: EP
authors.lastname: Fraher
authors.forename: Perri
authors.initials: P
authors.lastname: Morgan
authors.forename: Anna
authors.initials: A
authors.lastname: Johnson
mesh_terms: D006801:Humans; D009657:North Carolina; D009722:Nurse Practitioners / Q000600:supply & distribution*; D010823:Physician Assistants / Q000600:supply & distribution*; D011320:Primary Health Care / Q000639:trends; D013038:Specialization / Q000639:trends*; D000078329:Workforce