Acadiana nurses are filling a doctor shortage in Louisiana | Louisiana Health

As the supply of physicians lags behind patient demand across Louisiana and nationally, nurse practitioners are working to fill the gaps.

As the discrepancy between the number of doctors and need grows, patients end up waiting longer to see doctors — and doctors face burnout.

The U.S. is projected to have 120,000 too few doctors by 2035, with Louisiana projected to be short 4,820 doctors, according to the Cicero Institute. Already, Louisiana ranks in the bottom half of states for primary care and physician availability.

There are 3,500 or more patients for every one provider in Louisiana, with 60 of the state’s 64 parishes considered health professional shortage areas. 

The supply of new physicians is not looking good either, leading to the projected shortfalls. There are only 313 residency slots in Louisiana for primary care each year, and half of those residents will end up practicing out of state, according to the institute.

Nurse practitioners play an important role in bridging the gap in care left behind by the shortage of providers.

“The nurse practitioners have been an amazing asset,” said Trevis Badeaux, of Our Lady of Lourdes Regional Medical Center in Lafayette. 

Nurse practitioners can provide many of the same services primary care physicians can — with some exceptions. Their focus lies on preventative care: annual wellness checks, mammograms, lung cancer screenings, labs for high cholesterol and diabetes, as well as sick visits.

“If there are things that are outside of our scope of practice, then we will refer them to specialists as needed,” said Ashley Begnaud, a nurse practitioner with Lourdes who practices in Breaux Bridge.

Hayes and other nurse practitioners also partner with physicians to review treatment plans and overall patient care.

Nurse practitioners can prescribe most medications just like a physician. Although some services, such as chronic pain management with narcotics or weight loss treatment involving controlled substances are out of their scope of practice.

If those services are needed, nurse practitioners are likely to refer patients to either a specialist or a primary care doctor.

Having nurse practitioners to supplement the local cadre of primary care providers is especially advantageous for low-income patients, who are most heavily affected by the shortage of providers.

Hayes said she has seen this challenge among her patients, many of whom struggled to find providers before coming to her clinic.

“The Medicaid patients have trouble finding primary care providers, and then once they do get established with me, it’s difficult to send them to referrals to specialists,” Begnaud said.

While Louisiana’s Medicaid reimbursement rates are on par with the national average, physicians generally lose money the more Medicaid patients they treat compared to those with private insurance, which offer higher reimbursement rates.

As a result, Begnaud said, overall people who use Medicaid “get limited care, which is not fair to them, because they need health care like anyone else.”

The shortage of primary care physicians is especially dire in rural parishes.

“In some of our more rural locations, nurse practitioners are the sole provider of medical and mental health services,” said Roger Istre, chief operations officer at Iberia Comprehensive Community Health Center, which operates several clinics in rural locations across Acadiana and Central Louisiana. 

“Without them, we wouldn’t be able to reach patients in these areas — and, depending on the patient’s ability to travel, they may not get the care they need without our NPs,” Istre said.

While rural and low-income residents stand to benefit the most, all patients gain advantages from a more ample supply of local providers — allowing them to more easily find treatment where they live.

“Our main focus is always to treat patients here in Acadiana and keep them as close to home as possible,” Badeaux said. “You’re getting care from your neighbors, your friends, people you go to church with.”

And, he added, “being able to have family and friends that can be with you on your health care journey does have a great impact on your care.”

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