This winter, tens of thousands of college students will be traveling ho, ho, home for the holidays to see family, friends, and…their doctor?
College students under the age of 26 often stay on their parents’ insurance plans, but the coverage of these plans at out-of-state colleges is often lacking. Paired with a high preference for consistency in healthcare providers, many students delay care until they are home for the holidays and can book appointments with their in-town physicians.
The holiday rush causes an unexpected issue for the healthcare system: A month-long spike in the demand for providers at a time when many physicians are fully booked or traveling themselves. Wait times for physicians are significantly longer than they were in previous decades. This mismatch in supply and demand leads to access challenges in getting primary care appointments for both the students and the in-town community. Rural and low-income areas are hit even harder by this annual travel season, as they frequently have provider-to-patient ratios of well over 4,000 residents per physician.
More than 3,000 communities across the U.S. do not have enough physicians to serve their residents, leading to exacerbated wait times and frustrated patients. The holiday college student surge in hometowns across the U.S. can push these already limited rural or underserved communities beyond their ability to provide care.
Instead of leaving some patients without medical services, 27 states are better prepared for this demand surge through using nurse practitioners as autonomous primary care providers. These states allow nurse practitioners to diagnose and treat patients for all routine ailments and can refer patients to specialists, if more intricate and specialized treatment is necessary.
“Autonomous” does not mean nurse practitioners are refusing to collaborate. They frequently work in regular communication with multiple physicians and hospital systems. Instead, “autonomous” means nurse practitioners are not legally obligated to maintain expensive and strict contracts with physicians, limiting the ability for nurse practitioners to work in rural or disadvantaged areas. Many states refer to this as nurse practitioners’ full scope of practice, allowing providers to fully work to the extent of their graduate training.
Nurse practitioners are highly trained care providers, with graduate education and thousands of clinical hours. Unlike physicians who most often go into more lucrative specialties with higher reimbursement rates, over 85 percent of nurse practitioners remain in family and primary care working with the routine diagnostic and testing needs of patients.
The college population, on average, has significantly lower risks of needing complex care. The most common healthcare visits made by college students include routine check-ups, preventative care, STI panels, mental and behavioral health concerns, and medication refills. Nurse practitioners, who are extremely familiar and trained in this type of care, are more than capable of providing this routine care. This leaves physicians to spend more time with patients with specialized medical needs.
Having more autonomous primary care providers has had several benefits to the 27 states that implemented expanded practice authority for nurse practitioners. After removing strict collaboration contracts, there have been no measurable changes in safety, better routine care for rural patients, and lower malpractice rates among physicians. This is because physicians can spend more time with patients and less time filling out collaboration paperwork.
Students home for the winter break should not have to delay their medical care until summer because the hometown healthcare system was unable to adjust to patients’ needs. Many of the remaining 23 states with restricted practice policies are considering similar expansions for nurse practitioners in the upcoming 2024 legislative session.
If the red tape that prevents providers from serving communities in need is indeed cut, we may see healthier students returning to campus come springtime.
Alicia Plemmons is an Assistant Professor at West Virginia University and a Coordinator and Research Fellow at the Knee Regulatory Research Center.
