The Primary Care Problem
Primary care is falling behind. Millions of Americans don’t have a regular doctor. According to the Association of American Medical Colleges, the U.S. is projected to face a shortage of up to 55,200 primary care physicians by 2036.
That’s not a future problem. It’s already here. In many towns and cities, patients wait weeks to be seen. Some drive hours. Others skip care completely.
Emergency rooms pick up the slack. But they’re not designed for sore throats, minor injuries, or managing blood pressure. That mismatch costs patients time, money, and often leads to worse health over time.
Enter Nurse Practitioners (NPs)
Nurse practitioners aren’t new. They’ve been around since the 1960s. But now they’re stepping up in a big way.
NPs are advanced practice registered nurses. They hold master’s or doctoral degrees. They can diagnose illnesses, write prescriptions, order tests, and manage chronic conditions. In most states, they can do all this without a doctor’s supervision.
There are over 385,000 licensed NPs in the U.S. as of 2023, according to the American Association of Nurse Practitioners (AANP). And that number is growing fast.
Why Patients Choose NPs
NPs are filling gaps that doctors can’t. They often work in underserved areas—rural clinics, inner cities, schools, and walk-in centers.
Patients like seeing NPs. In surveys, NPs rank high for communication, listening, and time spent with patients. Many people say it feels more personal.
An NP in Ohio shared a story about a patient who came in thinking he had a cold. He left with a diagnosis of high blood pressure and a clear care plan. “I had the time to explain what it meant,” she said. “He told me, ‘No one’s ever broken it down for me like that.’ That’s the difference.”
Real Example: Lena Esmail
Lena Esmail, a nurse practitioner in Youngstown, Ohio, saw firsthand how people were slipping through the cracks. So she built something different.
She launched QuickMed, a network of clinics that use NPs and physician assistants as the backbone of care. Her clinics now operate in nine cities, including Akron, Liberty, and Ravenna. Many are inside schools or near neighborhoods that previously had no easy access to care.
“We’re built to fit into the community, not overwhelm it,” Esmail said. “It’s about being where people already are.”
That local-first approach is changing how people think about care. It’s also making it easier for families to get help before problems become emergencies.
NPs in Schools, Pharmacies, and Workplaces
NPs aren’t just in clinics. They’re working in schools to catch early signs of illness. They’re staffing retail pharmacies for walk-in visits. They’re supporting mental health programs and mobile care units.
School-based clinics have cut absenteeism and improved student health. At one Ohio school, a part-time NP helped reduce emergency room visits by 30% in one year.
Employers are also using NPs for workplace clinics. That reduces time away from work and keeps productivity up.
What Makes NPs So Effective
They’re Flexible
NPs can step into many care environments—rural or urban, in-person or mobile.
They Focus on Prevention
NPs often spend more time on education and health coaching.
They’re Cost-Effective
NPs cost less to train than physicians and often charge lower fees. That helps clinics serve more people with fewer resources.
They Close the Gap
In communities with doctor shortages, NPs become the frontline for care access.
The Stats Speak for Themselves
- 70% of nurse practitioners work in primary care
- 69% of patients say they’re comfortable seeing an NP for ongoing health needs
- Over 1 billion patient visits were handled by NPs in the last decade
- States that allow full NP practice tend to have higher care access in rural areas
What Needs to Change
1. Remove Practice Barriers
In some states, NPs are still required to work under physician supervision. That limits how far they can go—even when there’s no doctor nearby.
Recommendation: Support full-practice authority laws to let NPs work to the top of their license.
2. Fund More NP Training
We don’t just need more NPs—we need better pathways for nurses to specialize.
Recommendation: Expand scholarships and support programs that help RNs become NPs, especially in high-need areas.
3. Integrate NPs into Policy Planning
When healthcare systems or states make access plans, NPs often get overlooked.
Recommendation: Include nurse leaders at the table when designing care delivery models.
4. Educate the Public
Many people don’t know what NPs actually do.
Recommendation: Clinics, hospitals, and schools should include NPs in public health messaging, especially in underserved communities.
Action You Can Take Today
- Ask if there’s an NP at your local clinic or school.
- If you’re in healthcare, push for NP-friendly policies.
- If you’re a patient, try booking with an NP next time—and ask questions about how they can help you manage your care.
Final Takeaway
Nurse practitioners are changing what primary care looks like—and who gets it. They’re filling in the gaps left by doctor shortages and doing it with compassion, speed, and skill.
Their role isn’t secondary. It’s essential.
If the U.S. wants better access, especially in overlooked communities, supporting NPs isn’t a backup plan. It’s the way forward.
