Commentary: New Findings Substantiate the Successful Use of Nurse Practitioners and Physician Assistants in Collaborative Practice Models

On behalf of the Oncology Nursing Society (ONS), I'd like to first thank Susan G. Komen for the Cure for funding this very important and timely study of nonphysician practitioners (NPPs), which includes both nurse practitioners (NPs) and physician assistants (PAs).With more than 3,000 advanced practice nurse members, including NPs and clinical nurse specialists, ONS has a specific interest in the results of this study.ASCO projects that by the year 2020, there will be a shortage of medical and gynecologic oncologists, resulting in a deficit of 2,550 to 4,080 physicians caring for people with cancer.People are living longer, and, as Towle and Barr 1 point out, by 2020 the number of people living with or surviving cancer will increase by 81%.In addition, the Patient Protection and Affordable Care Act will provide health care access to approximately 42 million more adults and 8 million more children in the United States.Although not all of these newly insured people will present with or develop cancer, the number of patients requiring cancer care will undoubtedly increase as a result of improved access.Given that our health care system will experience a shortage of oncologists, who will care for all of these patients either living with or surviving cancer?As I noted in a recent edition of ASCO Post, "In my estimation, there is room for excellent cancer care provided by numerous health care providers including physicians, nurse practitioners, and physician assistants." 2(p2 ) Yet, historically, NPPs have not been used to their potential in caring for people with cancer.Towle and Barr 1 noted three reasons why NPPs have not been used in the past.