As the supply of doctors lags behind the demand for patients across Louisiana and across the country, doctors are working to fill the gaps.
As the gap between the number of doctors and demand increases, patients end up waiting longer to see doctors – and doctors face burnout.
The US is projected to have a shortage of 120,000 doctors by 2035, while Louisiana is expected to be 4,820 doctors short, according to the Cicero Institute. Currently, Louisiana ranks in the bottom half of states for primary care and physician availability.
There are 3,500 or more patients for every Louisiana provider, and 60 of the state’s 64 parishes are considered health professional shortage areas.
The supply of new doctors also doesn’t look good, leading to an expected shortage. There are only 313 residencies in Louisiana for primary care each year, and half of those residents will end up practicing outside the state, according to the agency.
Nurse practitioners play an important role in closing the care gap left by the provider shortage.
“The nurses have been an incredible asset,” said Trevis Badeaux, of Our Lady of Lourdes Regional Medical Center in Lafayette.
Nurse practitioners can provide many of the same services that primary care physicians can – with some exceptions. They focus on preventive care: annual health checkups, mammograms, lung cancer screenings, labs for high cholesterol and diabetes, as well as sick visits.
“If there are things that are outside of our practice area, we will refer them to professionals if necessary,” said Ashley Begnaud, a registered nurse at Lourdes’ practice in Breaux Bridge.
Hayes and other nurses also collaborate with doctors to review treatment plans and overall patient care.
Nurse practitioners can prescribe many medications just like a doctor. Although other services, such as drug management of chronic pain or weight loss treatment involving controlled substances are now available.
If those services are needed, nurses may refer patients to a specialist or primary care physician.
Having nurses supplement the local team of primary care providers is particularly beneficial for low-income patients, who are most affected by the shortage of providers.
Hayes says he has seen this challenge among his patients, many of whom struggled to find providers before coming to his clinic.
“Medicaid patients have a hard time finding primary care providers, and once they’re familiar with me, it’s hard to refer them to specialists,” Begnaud said.
Although Louisiana’s Medicaid reimbursement rates are about the same as the national average, doctors often lose more money to the Medicaid patients they treat compared to those with private insurance, which offers higher reimbursement rates. .
As a result, Begnaud said, in general people who use Medicaid “get less care, which is not fair to them, because they need health care like anyone else.”
The shortage of primary care physicians is particularly acute in rural parishes.
“In some of our rural areas, nurses are the only providers of medical and mental health services,” said Roger Istre, chief operating officer at the Iberian Public Health Center, which operates several clinics in rural areas throughout Acadiana and Central Louisiana.
“Without them, we wouldn’t be able to reach patients in these areas — and, depending on the patient’s ability to walk, they might not get the care they need without NPs.” ours,” Istre said.
Although rural and low-income residents benefit the most, all patients benefit from a wide range of local providers – allowing them to easily access treatment where they live.
“Our main goal is to treat patients here in Acadiana and keep them as close to home as possible,” Badeaux said. You get attention from your neighbors, your friends, the people you go to church with.”
And, he added, “being able to have family and friends who can be with you on your health care journey has a huge impact on your care.”
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