America faces a growing shortfall of physicians—especially in surgical specialties—and residency expansion alone won’t close the gap. National APP Week (Sept 21–25, 2026) highlights how advanced practice providers (PAs, NPs and others) extend surgeon capacity by managing pre‑ and post‑operative care, assisting in the OR and sustaining clinic access. Evidence links APP integration to better outcomes and lower costs, but scaling this approach requires financial and operational investment from hospitals, payors and policymakers.
National APP Week: How Advanced Practice Providers Multiply Surgeon Capacity Amid a Physician Shortage
APPs such as physician assistants or nurse practitioners often help assist in complex surgical procedures.getty
Advanced practice providers (APPs)—including physician assistants (PAs), nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists, midwives and anesthesiologist assistants—play a critical role in helping surgeons deliver timely, safe care. With growing shortfalls of physicians in surgical specialties, team-based models that extend a surgeon’s reach are essential to meeting patient needs.
Why APPs Matter Now
The Association of American Medical Colleges (AAMC) projects a nationwide physician shortfall of 13,500 to 86,000 by 2036, including a gap of 10,100 to 19,900 in surgical specialties. Increasing residency slots alone will not bridge that gap. In real clinics and operating rooms, what scales care safely is a team model that multiplies surgeon capacity without diluting surgeon responsibility.
What APPs Do
A complex spine operation does not end at skin closure. Patients need preoperative counseling, imaging review and authorization, clinic triage, overnight monitoring, wound checks, medication titration and countless micro-decisions that reduce complications. APPs perform many of these tasks: they staff clinics so new patients don’t wait months for a consult, first-assist and close in the OR, manage drains and postoperative pathways, and provide 24/7 in-house coverage at trauma centers.
Analogy: The surgeon is like the pilot—ultimately responsible—while APPs are crew and systems that keep the flight safe and on schedule.
Evidence And Workforce Trends
Analyses of Medicare data from single-specialty surgical groups that integrated APPs associate the model with fewer complications and readmissions, shorter lengths of stay, lower episode payments and more clinic visits per surgeon. Workforce data show APP capacity is expanding: the Bureau of Labor Statistics reported 168,900 employed PAs in 2025, with projected employment growth of 21% from 2025 to 2035; NPs have an even faster projected growth of 41% over the same period. Board-certified PA numbers surpassed 200,000 in 2025.
Barriers To Scaling APP Contributions
The bottleneck is not APP supply but whether health systems, payors and governments integrate and fund APPs as partners rather than treating them as mid-level or optional overhead. Sustainable models require clear job design, financial integration, training pipelines and competitive retention strategies so APPs can be embedded as essential capacity within care teams.
Real-World Example
At the University of South Alabama and USA Health Spine Institute, APPs are central to care delivery. Our PA and NP team often provides the first specialist contact for spine patients, prepares and assists in cases, manages clinic follow-up and maintains continuity so attending surgeons can focus on the operative decisions that require their expertise. APPs also enable 24/7 neurosurgical coverage at a Level I trauma center, triaging and stabilizing patients until the attending arrives.
What APPs Do Not Do
APPs are not a substitute for surgeons. They cannot produce more surgeons overnight nor do they replace the highest‑complexity decisions and operative skills that only surgeons provide. Instead, APPs let surgeons safely care for more patients—more clinic visits, better-prepared cases and more postoperative follow-ups—without forcing patients to wait for every answer from the one person who cannot be in two places at once.
Call To Action
National APP Week (September 21–25, 2026) is an opportunity to recognize how team-based care improves access and outcomes. Scaling this model will require investment from hospitals, payors and policymakers in recruitment, training, compensation and service-line integration so surgeons and APPs can deliver the right care at the right time.
Bottom Line: APPs are force multipliers for surgeon capacity—essential teammates who preserve continuity, safety and access in high-acuity care.
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