The Evolving Role of Mid-Level Providers in Healthcare

The pandemic shed light on a major gap in the healthcare system–a physician shortage that became a very apparent problem in urgent care, hospitals, primary care, and specialty practices. As a result, it has accelerated the need for mid-level providers like nurse practitioners (NPs) and physician assistants (PAs) to take on more prominent roles. There’s been a steady increase in NPs and PAs for the past decade, and now more than ever, their roles are becoming undeniably integral to the healthcare system.

Increasing Accessibility & Quality of Care

The role of these mid-level providers is crucial to achieving comprehensive patient care. They can see patients with lower-acuity issues, and fill in gaps in areas like telehealth and routine care so physicians can spend more time on patients with complex health concerns. This provides patients with better access to care and allows practices to focus on the quality of healthcare being delivered.

As providers are realizing the benefits of utilizing mid-level providers, they are starting to show up more prominently in different areas of the healthcare system. But what does this look like for patients and other players like pharma and biotech companies that will be interfacing more frequently with these mid-level providers?

In Primary Care

It’s estimated that the use of NPs and PAs in primary care could reduce the primary care physician shortage by 70%. Mid-level providers can see patients face-to-face to help with patient volume and conduct a lot of the routine work–like paperwork, triaging, and prescribing medication–to free up physicians to focus on more complex patients’ needs. NPs and PAs already prescribe over 41% of medications for patients in the US, and that number will likely continue to increase.

Another key area where these providers offer value is telehealth. With an increase in telehealth since the pandemic, they are able to support and streamline the virtual process to increase convenience, improve access, and improve care models and health outcomes. In many cases, telehealth care is more affordable for patients and can be integrated into a hybrid care model that consists of in-person and virtual care.

In Specialty Practices

Gynecology, Pediatrics, and other specialty practices are also seeing these mid-level providers’ roles increase in capacity. A good example of this is in psychiatry–where mid-level providers are able to help expand access to patients, in this case to mental health care. Joe Parks, MD, at the National Council for Behavioral Health says, “We will never meet everybody’s needs seeing all of the patients ourselves.” Using mid-level providers allows him to spend more time in person with patients who require consultations and less time doing things like routine medication refills. This has greatly increased patient access to care.  Before mid-level providers were integrated, patients would wait months to see a psychiatrist.

In specialty practices like Parks’, mid-level support also allows physicians to do more of the high-level work they’ve been trained to do, and less of the routine work that can be taken on by other qualified providers.

In Hospitals & Urgent Care

There is also a vast opportunity for mid-level providers in urgent care and emergency rooms, and that was proven during the pandemic. Mid-level providers help the overall success of urgent care and emergency rooms, not only by providing a more consistent quality of care but also by offering a more successful staffing model. Jacquelin Houze, FACMPE, practice manager at St. Elizabeth Physicians, noted in MGMA Connection magazine, that the staffing model chosen for an urgent care clinic “directly correlates to the clinic’s success and the contentment of providers and staff,” which can improve retention rates for medical providers and support staff. When support staff, mid-level providers, and physicians have manageable roles within high-stress practices, they are less likely to get burnt out. Mid-level providers help balance the roles of both support staff and physicians with their ability to step in to fill medical and administrative gaps.

Effects On the Healthcare System

It’s clear that as mid-level providers take on broader roles, it can positively affect patients. Along with quality care, patients want to be seen and heard, and expanding the roles of mid-level providers gives patients more access and more comprehensive care. This will lead to a more positive treatment experience. Likewise, practices benefit from a more effective staffing model that includes mid-level providers and allows more balance between the roles of support staff and providers.

What about other parties that typically interact with physicians? For pharma and biotech companies, the growing roles of mid-level providers have huge implications. NPs and PAs are writing prescriptions, they often make decisions independent of physicians, and they even play a role in the purchase of medical equipment. This means that pharma and biotech companies need to learn to market to mid-level providers and interface with them as decision makers. This requires an understanding of mid-level providers’ specific needs and how they can benefit from what these companies are offering as their roles and responsibilities change. Pharma and biotech companies need to make the conscious shift to engaging these providers more intentionally as their role will only continue to grow. This can be achieved through a variety of efforts, from rep engagement to non-personal promotion via email marketing or medical association and conference sponsorships. 

The future of health care will see practices continue to employ and utilize mid-level providers because of the benefit they provide, and other contributors to the healthcare system will need to adjust to account for their evolving role.