December 1, 2023

The last couple of years have seen a seismic evolution in the health care industry. The onset of the COVID-19 pandemic led not just to technological advances such as mRNA vaccines — out of necessity it also triggered a quantum leap in how medical practitioners at all levels approach providing care, including an almost overnight revolution in virtual consultations and telemedicine.

To get a glimpse at where all of this may be headed next, we spoke to doctors and health industry experts around the state. Here are 10 changes they see on the horizon, from who you’ll deal with (more assistants and women doctors) to how (the return of house calls?)

Your medical care team will expand

The U.S. faces a critical physician shortage, and by 2034, the gap between physician supply and demand will range from 37,800 to 124,000, with shortfalls in both primary and specialty care, according to the Association of American Medical Colleges. Patients in Connecticut should expect to see advanced practice providers (APPs), including physician assistants (PAs), nurse practitioners (NPs), certified nurse midwives (CNM) and certified registered nurse anesthetists (CRNA) filling that gap. These licensed health care providers diagnose and treat patients, prescribe medications and perform or assist with surgical procedures. 

APPs undergo extensive education at the undergraduate and graduate school level, with training in both medicine and “soft skills” such as communication, listening, leadership, compassion and professionalism. On a basic level, NPs, Advanced Practice Registered Nurses (APRNs) and CRNAs are registered nurses with advanced clinical training; a PA is trained following a disease-centered medical model like physicians. The number of people in each profession is expected to grow quickly — 31 percent between 2019 and 2029 for PAs and 45 percent for NPs, according to the U.S. Bureau of Labor Statistics. 

The need for additional providers came into greater focus during the COVID-19 pandemic, which led to delays in other medical care. That left patients and providers trying to catch up on services, including screenings and chronic-condition follow-up, says Johanna D’Addario, president of the Connecticut Academy of Physician Assistants. “In many cases, PAs have availability to see patients who need urgent appointments when the physician is not available,” she says. “It might be helpful for patients to know that PAs work closely with physicians in a team approach, and are able to arrange for the patient to see the physician as soon as possible when needed.”

The medical community is aware of the doctor shortage, but medical school seats are limited. PAs, meanwhile, don’t have to do a residency like doctors and can get “out into the workforce more quickly than physicians,” says D’Addario, a physician assistant at Yale New Haven Hospital, “but we’re still limited by the number of seats in PA programs across the country.” Physicians, PAs and NAs all need training sites. “We have to be very cognizant of not overburdening the current medical system with students.”

“I work with PAs, nurse practitioners and APRNs. They play a very important role in my own practice,” says cardiologist Dr. Bruce T. Liang, interim CEO of UConn Health. “If I see a new patient, the next visit could be with a nurse practitioner or a PA. We alternate. There’s mutual respect and dependence. We work as a team.” — Theresa Sullivan Barger


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