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PA and NP general practice employment in the Netherlands
Geert Twj van den Brink1, Arjan J Kouwen, Roderick S Hooker
1Geert TWJ van den Brink practices at Radboud University Medical Center and is director of the master PA program at HAN University of Applied Sciences, both in Nijmegen, Netherlands. Arjan J. Kouwen is manager of organ donation and transplantation for the Dutch Federation of University Medical Centers in Utrecht, Netherlands. Roderick S. Hooker is a US-based health policy consultant. Hester Vermeulen is a professor of nursing sciences at IQ Healthcare, Radboud University Medical Center, in Nijmegen. Miranda GH Laurant is a professor of organization of healthcare and services at HAN University of Applied Sciences and a senior researcher at Radboud University Medical Center. The authors disclose that this research was funded by the Netherlands' Ministry of Health. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
Abstract:
General practitioners (GPs) are the cornerstone of primary healthcare in the Netherlands. As a national strategy, physician associates/assistants (PAs) and NPs were introduced to address growing healthcare demand. In this study, four representative practices were analyzed quantitatively and qualitatively-two solo practices with a PA or NP and two group practices with a PA or NP. A reference group of GPs served as experts. The annual encounters per full-time GP averaged 6,839; for the NPs, 2,636; and the PAs, 4,926. Billable services were 70% to 100%, averaging 71% for NPs and 85% for PAs, and in three of the four practices, the employment of the NP or PA was cost-efficient. The qualitative data show that PAs and NPs contribute to general practice, easing the workload so that the GP has more time for complex patients. PA and NP employment was financially beneficial in 75% of cases.
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