Nurse Practitioners and Their Effects on Visits to Primary Care Physicians

The demand for primary care services is expected to increase at a time of persistent shortages of primary care physicians (PCPs) in the United States. A proposed solution is to expand the role of other allied health professions. This study examines the causal effects of visits to nurse practitioners (NPs) on the demand for services from PCPs. We employ a system of simultaneous equations and dynamic panel estimators to control for endogeneity of visits to NPs. Results indicate that patients who visited an NP are significantly less likely to visit PCPs and to receive prescribed medication, medical check-up, and diagnosis from PCPs. Findings were robust to other specification and passed a falsification test. The results suggest that the use of NPs could serve as a potential option to address shortages in supply of primary care services.