In today’s health care system, primary care is stretched thin. Patients face longer wait times, providers are burned out, and practices are under constant pressure to do more with less time in their hands. In the middle of this strain, I have noticed a troubling trend, divisions between physicians (MDs, DOs) and nurse practitioners (NPs) or physician assistants (PAs).

I strongly believe that patients and even all of us do not benefit from division. We all benefit from collaboration.

Different roles, one shared mission

Yes, physicians and NPs/PAs come from different training backgrounds, and each brings unique strengths to the table. Physicians have years of medical school and residency training, often with deep expertise in diagnostics and complex case management. Nurse practitioners or physician assistants on the other hand are trained with a holistic, patient-centered approach, often excelling in communication, prevention, and continuity of care.

Instead of competing, imagine the impact when both perspectives are combined:

• Patients receive thorough, evidence-based care
• Providers share the workload and reduce burnout
• Practices run more efficiently and sustainably

My experience in primary care

In my own everyday medical practice, I have seen firsthand how collaboration changes everything. Working side by side with nurse practitioners has helped us serve patients better and create a sense of shared purpose.

When MDs/DOs and NPs/PAs truly align, I strongly believe and witnessed firsthand that the result is not only better outcomes but also greater job satisfaction. For me personally, optimizing teamwork and workflows has allowed me to reduce my patient load to sixteen per day, three days a week, while still increasing my revenue. That balance is possible when we see each other as partners, not competitors.

The financial advantage for both MDs and NPs/PAs

Collaboration is not just good for patient care; it is also financially smart, even in employed clinic settings.

• Higher revenue per provider: When visits are optimized, preventive services are captured, and proper billing codes are used, all physicians and NPs/PAs contribute more revenue to the practice. In most systems, productivity is measured in RVUs or bonus incentives, meaning everyone benefits when revenue per visit increases.
• Stronger job security: Clinics thrive when their teams generate more value without adding burnout-driven turnover. A financially healthy clinic is more likely to retain staff, invest in resources, and reward providers.
• Fairer compensation: Even in salaried roles, many providers have performance-based incentives tied to patient satisfaction, quality metrics, or revenue capture. MDs/DOs and NPs/PAs who collaborate often see higher scores in these areas, translating into bonus pay.
• Sustainability: By sharing the workload, all MDs/DOs and NPs/PAs can focus on what they do best, reducing errors, minimizing burnout-related absences, and sustaining long-term earning power.

Simply put: Collaboration increases financial stability and career longevity for everyone on the team.

Why this matters more than ever

The demand for primary care is growing, yet the provider shortage continues. We simply cannot afford to waste energy on turf battles. Every ounce of focus must go toward what matters most: patients.

By supporting one another (MDs/DOs, NPs, and PAs), we can:

• Shorten wait times
• Deliver more comprehensive visits
• Free up time for providers to recharge and prevent burnout
• Strengthen trust with patients, who care less about your title and more about feeling heard, cared for, and safe

The investment we must make

Unfortunately, no one teaches us in school how to collaborate across disciplines, nor how to optimize workflows, billing, and practice management to protect ourselves and thrive. That is knowledge we have to actively seek out.

From my perspective, investing in collaboration and practical knowledge (whether in billing, workflow, or communication) is one of the best things we can do as providers. It protects our profession, increases revenue, and gives us the balance we all deserve.

A call to my colleagues

If you are reading this and working in primary care (whether you are an MD, DO, NP, or PA), I strongly recommend: See each other as allies, not rivals.

Together, we can create practices that are not only financially sustainable but also deeply rewarding, for us and for the patients who rely on us. At the end of the day, we share the same mission: to heal, to serve, and to make primary care stronger.

Jerina Gani graduated with high honors from medical school in Albania, Europe, in 1992. She later earned a Master of Science degree in Health Services Management from the London School of Hygiene and Tropical Medicine in the United Kingdom. In 1995, she relocated to the United States and completed her residency training in internal medicine in Brooklyn, New York. Since then, she has practiced as a primary care physician in Boston, Massachusetts. With decades of experience in the medical field, Dr. Gani is deeply committed to transforming primary care into a model of success and balance. Her professional focus emphasizes improving health care delivery while maintaining physician well-being. Dr. Gani shares her insights and strategies for achieving these goals through her platform at Dr. Gani Secrets, where she engages with health care professionals and the broader community.