Medical Student Attitudes Toward Advanced Practice Provider Independence Legislation

In response to the national primary care physician shortage, states are increasingly turning to legislation that expands the scope of practice for advanced practice providers (APPs), such as nurse practitioners (NPs) and physician assistants (PAs) to practice independently without physician oversight. While the effects of these laws will be multi-faceted, little is known regarding how these laws will affect states' future abilities to attract and recruit physicians to practice within their state. This study explores medical students' (MSs) attitudes toward APP independence legislation, focusing on their perceptions of equivalency of care, the potential impact of these laws on their future practice choices, and their views on professional collaboration.

An anonymous survey was administered to MSs across all 4 years of schooling at a Midwestern medical school.

This survey had a 21% (109/518) response rate. 86% of MSs expressed disagreement that APP care is comparable to physician care. In addition, 59% of respondents reported they would be less likely to practice in states allowing APP independence, a figure rising to 71% among those interested in pursuing primary care.

The majority of MSs do not view APP-driven care as equivalent to care delivered by a physician. Further, states that enact APP independence laws may struggle to attract future physicians as the majority of MSs in this study consider the legislative landscape of the state they practice in.

States considering APP independence laws should consider the results of these studies when attempting to address their physician shortage.