Primary Care Nurse Practitioners and Physicians in Low-Income and Rural Areas, 2010-2016


Ying Xue, Joyce A. Smith and Joanne Spetz

January 8, 2019

Nurse practitioners (NPs) constitute the largest and fastest growing group of nonphysician primary care clinicians. As the primary care physician (PCP) shortage persists, examination of trends in primary care NP supply, particularly in relation to populations most in need, will inform strategies to strengthen primary care capacity. However, such evidence is limited, particularly in combination with physician workforce trends. This paper characterized the temporal trends in the distribution of primary care NPs in low-income and rural areas compared with the distribution of PCPs.


From 2010 to 2016, physician supply remained relatively constant. NP supply increased more than physician supply. Similar trends were observed in metropolitan, urbanĀ and rural HSAs. Primary care NP supply increased more than physician supply in metropolitan areas, in urban areas, and in rural areas. By 2016, the highest NP supply was observed in rural HSAs, whereas the highest physician supply was in metropolitan HSAs.

Read the full publication in JAMA.