The U.S. healthcare system is in the middle of a transformation driven by an ongoing shortage of primary care physicians. It’s not a looming threat but today’s reality. More than 100 million Americans lack access to a primary care provider.¹ By 2036, the physician shortfall is expected to reach 86,000. Rural and underserved communities are especially hard hit.²˒³
At the same time, patient behavior is shifting. Traditional primary care visits are on the decline. More patients are turning to retail clinics, urgent care centers, telehealth, and most notably—nurse practitioners (NPs) and physician assistants (PAs). These non-physician providers (NPPs) are no longer just supporting care delivery; they are leading it.⁴˒⁵
Filling the gap, but with new rules
NPs and PAs have stepped up to fill this widening care gap. As of August 2024, more than half of U.S. states grant full practice authority to NPs, enabling them to independently diagnose and prescribe. But while they are helping maintain access to care, this shift is also redefining how clinical decisions are made.⁶
For pharma, this isn’t just a new audience—it’s a new reality. These providers bring different perspectives, priorities, and needs. Sales teams, medical science liaisons (MSLs), and marketers who continue to rely on physician-centric engagement models risk missing the mark.⁷
Engaging a new kind of decision-maker
To succeed in this evolving landscape, pharmaceutical teams must understand how to engage a new kind of decision-maker—one who operates at the intersection of care delivery and patient advocacy.
NPPs often approach prescribing with a patient-centered, preventive care lens, focusing on holistic treatment over acute intervention.⁸
They may prioritize different clinical concerns, such as health equity, lifestyle interventions, or cost transparency.⁸
Their workflows may be different than those of traditional primary care providers, incorporating digital tools like AI-enabled symptom checkers, decision support platforms, and asynchronous communication to manage high patient loads more efficiently.⁹
Their continuing education needs differ from physicians, and traditional rep resources may fall short—particularly if they lack applicability to team-based care or digital-first environments.⁸
NPPs also tend to be more skeptical of traditional industry outreach and often prefer evidence-based dialogue, real-world data, and resources that support patient education.⁸˒¹⁰ Understanding their motivations, responsibilities, and clinical contexts is foundational to effective engagement. In many cases, NPPs serve not only as decision-makers but also as influencers within interdisciplinary teams and their communities.⁸˒⁹
To build meaningful relationships with NPPs:
Conduct in-depth research to understand their clinical priorities and practice settings
Personalize communication based on individual needs, values, and behaviors
Build trust through consistent, transparent, and evidence-backed content
Share case studies, success stories, and peer-endorsed tools to establish credibility
Engage through multiple channels—webinars, social platforms, and in-practice conversations
Host interactive events like roundtables or clinical workshops that facilitate two-way dialogue
Technology and training
AI and digital tools are also reshaping how care is delivered and how pharma engages—and NPPs are often early adopters. Their openness to these tools stems from the demands of primary care: limited time, complex patient needs, and a strong emphasis on prevention. By leveraging AI-enabled decision support, digital symptom checkers, and asynchronous communication platforms, NPPs can provide more holistic, efficient care that emphasizes access and patient trust.⁸˒⁹
According to the American Association of Nurse Practitioners, many NPs report using digital health tools to improve efficiency in managing chronic conditions and preventive services, as well as enhancing patient communication.⁸ As more care moves to digital settings, and as NPPs adopt AI-supported decision-making tools, reps and MSLs need fluency in these technologies.
Training must now address⁹:
Digital engagement strategies tailored to NPP workflows
Building trust and rapport in hybrid or asynchronous interactions
AI literacy, to communicate credibly with tech-enabled providers
Soft skills, to navigate new power dynamics and clinical priorities
From awareness to action
This is more than a shift in who prescribes; it’s a shift in how care is delivered, who holds influence, and what support they expect from pharma.
Are your teams prepared to meet a decision-maker who sees patients through a different lens? One who may be skeptical of industry interactions, pressed for time, or more interested in patient education than product specs?
The path forward
The future of primary care is already here—and it looks different. NPPs are central to sustaining access, but they come with distinct clinical perspectives. Pharma teams that invest in understanding and adapting to this audience will be better positioned for long-term relevance.
For learning and development leaders, this is the moment to rethink how reps, MSLs, and marketers are trained. It’s not just about product knowledge anymore; it’s about navigating a transformed healthcare landscape.
Pharma success in 2030 starts with how we train our teams in 2025. Are you ready?
References
National Association of Community Health Centers. Closing the primary care gap. Updated 2023. Accessed May 2025.
Association of American Medical Colleges. New AAMC report shows continuing projected physician shortage. Updated 2024. Accessed May 2025.
American Medical Association. Powerful Senate committee takes up physician shortage. Updated 2024. Accessed May 2025.
National Academies of Sciences E, and Medicine,, Health and Medicine Division, Board on Health Care Services, et al. Implementing high-quality primary care: Rebuilding the foundation of health care. In. Primary Care in the United States: A Brief History and Current Trends. Washington DC: National Academies Press; 2021.
Healthcare Finance. Fewer clinicians entering primary care, data shows. Updated 2025. Accessed May 2025.
American Association of Nurse Practitioners. Issues at a glance: Full practice authority. Updated 2025. Accessed May 2025.
Zhang P, Patel P. Practitioners and prescriptive authority. In. StatPearls. Treasure Island, FL: StatePearls Publishing; 2023. Accessed May 2025.
American Association of Nurse Practitioners. Achieving health equity through better understanding. Updated 2023. Accessed May 2025.
McKinsey & Company. Transforming healthcare with AI: The impact on the workforce and organizations. Updated 2020. Accessed May 2025.
O'Reilly KB. Physician and nonphysicians: What are the differences? San Diego Pyschiatric Society. Updated 2024. Accessed May 2025.
