To keep up with the anticipated 712,000 new positions, BLS predicts that the nursing workforce also needs to expand by 495,500. The American Journal of Medical Quality in 2012 predicted the worse of these shortages will be in the South and West regions of the country, which happens to be where the tightest APRN scope of practice restrictions are.
2. Doctors resent them on the front lines and in the board rooms
Despite the primary care shortage, The American Academy of Family Physicians released a report in September 2012 arguing that "The interests of patients are best served when their care is provided by a physician or through an integrated practice supervised directly by a physician… We must not compromise quality for any American, and we don't have to."
"I think a lot of this turf tension is the whole prestige issue about how physicians are revered. There's a combination of things, part of it is money, and part of it is around not being the one in charge. The team approach is spreading not only the workload, but also the component of who is in charge here. But it shouldn't be like that, it should be that whoever can provide care at the time should be in charge," says Mary C. Smolenski, EdD, MS, FNP, CAE, FAANP. She is a consultant and writer on advanced practice issues and the former Director of Certification Services for the American Nurses Credentialing Center, a subsidiary of the American Nurses Association.
According to Knybel at Randstad, if an APRN decides to voluntarily leave a position, more often than not it is because he or she didn't have the support of the physician or the physician teams. She says engaging the physicians in the decision to hire more nurse practitioners are a way to avoid this conflict.