The viability of mid-level practitioners in isolated rural communities

In the last decade there has been an increasing emphasis on providing equal access to health for all citizens of the United States. Rural dwellers have been identified as a population group who experience significant barriers to gaining access to the traditional health care delivery system. The problem becomes more acute for the target population that is more remote from larger communities. One potential solution in which significant investment has been made is the training and use of nonphysician health providers for the delivery of primary health care services. This study examines the attempt of the National Health Service Corps (NHSC) in the Pacific Northwest (Washington, Oregon, Idaho) and Alaska to use non-physician health providers (physician assistants and nurse practitioners) to solve the health care needs of the geographically isolated community. It focuses on an analysis of the financial growth and evolution of this type of practice and draws some preliminary conclusions about the economic viability of the model.