JMIR Publications

ABSTRACT

Background:

The coronavirus (COVID-19) pandemic overburdened primary care clinicians. For nurse practitioners (NPs) to alleviate the burden, the public must be willing to see a NP over a physician. Those with poor health tended to continue seeking care during the pandemic, suggesting they may be willing to see a NP.

Objective:

Evaluate the public’s willingness to see a NP for primary care and how this may be associated with their beliefs about the local supply of physicians and self-rated health. Conduct a survey to identify correlations and an experiment to assess how willingness is dependent on information about the local supply of physicians.

Methods:

The survey and experiment were conducted in April and December 2020, respectively. The survey measured beliefs about local physician supply, while the experiment manipulated beliefs via altering information the participants read about the local supply of physicians. Multiple regressions and analysis of variance were used to assess willingness to see a NP. Willingness to see a NP was assessed as an overall preference over a physician and as a preference given two clinically significant scenarios (coughing and headache). Self-rated health was a dichotomized five-point scale.

Results:

The survey showed concerns about physician supply lowered willingness to see a NP among respondents with comparatively better health, but raised willingness among respondents with comparatively worse health. The experiment suggests only the latter is causal. For the two clinically significant scenarios, these patterns appeared for the coughing scenario in the survey and the headache scenario in the experiment.

Conclusions:

U.S. adults with comparatively worse self-rated health become more willing to see a NP for primary care when they hear information that raises their concerns about the local physician supply. The differences between the survey and experiment results may be useful for interpreting findings from future studies. Findings may aid in managing finite health care resources during public health crises and crafting successful messaging by NP advocacy groups.