Lane County was on the brink of a healthcare crisis. A shortage of primary care physicians, physician assistants and nurse practitioners had been documented in a variety of reports by the Oregon Health Authority. In addition, large numbers of primary care workers in Lane County retired and the Trillium Community Health Plan CCO, reported about 11,000 new members without a designated primary care provider.
This Oregon Solutions project aimed to increase access to primary care by increasing the numbers of physician assistants and nurse practitioners being trained and working in Lane County.
There was a documented shortage of physician assistants (PA) and nurse practitioners (NP) in Lane County. The report titled Projected Demand for Physicians, Nurse Practitioners, and Physician Assistants in Oregon: 2013-2020 by the Oregon Health Authority (revised Feb. 2014), says that in 2020 there will be a provider shortage of PAs (6-22) and shortage of NPs (20-49) in Lane County. These numbers do not include retirements, any reduction in practice hours and relocations out of the community. These numbers are not exclusive to primary care, they are PAs and NPs engaged in any type of practice.
Governor Kate Brown designated this effort an Oregon Solutions project in a May 21, 2015 letter. Governor Brown appointed Juine Chada (US Senator Wyden’s Office) and Debi Farr (Trillium Community Health Plans Public Affairs Director) as co-conveners to lead a team of primary care providers, health care organizations and higher education organizations to create a plan to increase the number of PAs and NPs delivering primary healthcare services in Lane County. The Oregon Solutions (OS) project team participants represented a crosssection of the community.
Project team members learned that it is critical to recognize that, in some respects, PAs and NPs are significantly different in their training, philosophy and professional practice with patients. The project team initially identified three key areas to focus their efforts:
- increasing clinical rotation/practicum capacity,
- locally enhancing student incentives, and
- exploring whether local didactic classroom capacity was needed in Lane County.
The project team developed a Community Action Plan and as well as signed the Declaration of Cooperation (DoC). The goals and aspirations represented in the DoC formed a public statement of intent to participate in the project, to strive to identify opportunities and solutions whenever possible, to contribute assistance and support within resource limits, and to collaborate with other team members in increasing the number of PAs and NPs providing primary care in Lane County. Team members acknowledged that the best solutions depend upon the cooperation by all entities at the table. Accordingly, they recognizes that each party has a unique perspective and contribution to make and legitimate interests that needed to be taken into account for the project’s success.