Comparison of Specialty Distribution of Nurse Practitioners and Physician Assistants in North Carolina, 1997-2013

May 1, 2015

Perri Morgan, PhD, PA-C; Anna Johnson, PhD, MSPH; Erin Fraher, PhD, MPP

Presentation at the 2015 AAMC Health Workforce Research Conference



  • Expected increase in demand for healthcare services in the US
  • Physician supply may not be adequate to meet demand under traditional models of care
  • NPs and PAs might help fill service gaps in primary and specialty care, but estimates of this potential vary
  • Analyzed licensure data from the NC Health Professions Data System
  • Large growth in both professions led to larger numbers of NPs and PAs in most specialties
  • Specialty distributions changed over time for both NPs and PAs
  • NP proportions increased in medical subspecialties and decreased in pediatrics and Ob/Gyn
  • PA proportions decreased in primary care, increased in medical subspecialties, and were high in urgent care in 2013
  • What affects specialty distribution:
    • Supply: factors affecting individual provider specialty choice
    • Demand: factors inducing organizations to hire NPs/PA
  • NPs and PAs are a growing and flexible workforce available to meet emerging healthcare needs
  • Important similarities and differences between NPs and PAs should be considered in workforce design
  • Policies designed to affect specialty distribution of NPs and PAs should attend to both supply and demand factors


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This work is funded through cooperative agreement U81HP26495, Health Workforce Research Centers, with the National Center for Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration, U.S. Department of Health and Human Services. The content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.