In the United States, the prominence of “physician extenders” in providing healthcare is evident. Primary health care providers are increasingly including unconventional healthcare professionals. Mid-level practitioners, chiefly recognized as physician assistants and nurse practitioners, are becoming the frontline workers in providing access to routine care and, in some cases, emergent care. The field is evolving to allow for sub-specialization and expanded autonomy with minimal direct physician supervision. The healthcare force for these disciplines is growing in numbers and continually attracts more candidates. Reasons attributable to this growth, to name a few, are increased recognition and respect for the field, enhanced autonomy, competitive remuneration and benefits, and profession prestige.
The shortage and uneven distribution of primary care physicians were the catalytic foundation of these professions. These same grounds are experienced by countries in West Africa, but resistance to the development of mid-level practitioners exist. This is partially due to the perception that the quality of medicine delivered is sub-optimal. There is a high degree of pride that flourishes within these nations and the notion of a “less-than-qualified” personnel providing primary healthcare is an undesirable substitution. In my opinion, transitioning the healthcare model to adapt these specialties will abridge the healthcare access disparities that exist in these regions, especially in light of the physician shortage experienced due to migration.
The introduction and integration of these professionals may encounter resistance due to the view that these practitioners are unskilled. It will, therefore, require tactical gradual infiltration by means of cultural adjustment. It is to my knowledge that health outcome measures for mid-level practitioners in comparison to physicians have demonstrated to be analogous in primary care. Transparency of high-quality health care outcomes and testimonials from patients may help illuminate competence and encourage acceptance. The diminishing health status of the abovementioned regions requires uncomplicated noninvasive interventions deliverable by competent personnel such as the mid-levels. The availability of these providers will assist in achieving health goals.