Foreword

Article Outline

• Copyright

Access to health care is one of the fundamental principles of primary care. A potential perfect storm of issues threatens access to health care in the United States. As a member of the aging baby boomer cohort, I can personally attest to the increasing utilization of the health care system by this group. At the same time, calls for universal health care might provide opportunities to access health care for members of our society that previously did not have the resources to seek health care. Lurking in the background are increasing pressures on physicians that have led many to retire earlier than the previous generation of physicians.

One solution to address the growing shortage of physicians and access issues is midlevel providers. Nurse Practitioners (NPs) and Physician Assistants (PAs) have an important role now and are likely to play an even more important role in the future. The numbers of NPs and PAs has more than doubled since 1990, and their numbers continue to grow. Despite the critical role of NPs and PAs in the health care systems, many primary care physicians still do not have a good grasp of their training, licensing, and the scope of the care they can provide.

In this issue of Disease-a-Month, Bednar and her colleagues do an excellent job of outlining the role of NPs and PAs in primary care. They describe the education and training of midlevels and also discuss accreditation, licensing requirements, and the scope of services. For those who are considering collaborating with midlevels, this issue will provide an excellent overview. In addition, providers who work with midlevels are likely to find useful information about the training and licensing of their colleagues. If you have no experience working with PAs and NPs, understanding the material presented here will be important for developing an understanding of the crucial role of these providers in developing new health policies and planning to meet the societal health care needs of the future.