Since the introduction and continued implementation of the Affordable Care Act, millions of individuals now have access to health care who did not before. With this influx of patients in the health care system, there has been an increased demand for primary care providers in a health care environment already dealing with shortage, (Buppert, 2015)A large amount of this population includes patients battling diabetes and hypertension. These patients would benefit from a nurse practitioner specializing in these diseases such as an family nurse practitioner (FNP) with a subspecialty in endocrinology.
According to (data usa), in our community of Corpus Christi, there is a population of 361,350 with 76 primary care physicians for every 100,000 people. This is much lower than the 150 primary care physician to 100,000 ratio that is the average for the United States, (America’s Health Rankings). FNPs are needed to help lessen this shortage of primary care providers. NPs are choosing primary care more than physicians and physician assistants. In 2017, more than 87% of NPs were prepared in primary care programs, while only 14.5% of physicians entered a primary care residency, (storage?). Currently 60.6% of nurse practitioners are FNPs with 46.2% working in the primary care setting. 84.9% of NPs are accepting Medicare patients and 82.9% are accepting Medicaid patients, (storage aanp). Due to the increased patient demands and shortage of physicians, the amount of active NPs in both primary care and specialty settings is expected to increase 141% by 2025, (https://doi.org/10.3928/01484834-20180720-11).
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There is a need for FNPs in the primary care setting specializing in endocrinology due to the combination of increases in patients who are insured and patients with diabetes, prediabetes, and comorbidities such as hypertension. There are more than 100 million U.S. adults who are currently living with diabetes or prediabetes in the United States according to the Center for Disease Control (CDC). 30.3 million of these adults, or 0.4% of the US population has diabetes and 84.1 million adults have prediabetes, (CDC). In Texas, 11.4% of the population has diabetes which is higher in comparison to the 9.4% who have diabetes in the United States, (dshs pdf). The combination of the lower primary care physician to patient ratio and higher patient population with diabetes in Corpus Christi shows the need for FNPs specialized for this population.
The Health Resource Services Administration has recognized the need for an increased amount of FNPs with an endocrinology subspecialty and has given funding for the first endocrinology specialty training program for primary care nurse practitioner students at the Duke University School of Nursing. This program prepares primary care nurse practitioner students to manage complex diabetes mellitus, general endocrine conditions, and comorbidities. It also sets a model for graduate nursing schools to add more primary care subspecialty curriculum for future students, (https://doi.org/10.3928/01484834-20180720-11)
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