NP and PA Presidents Discuss Workforce Shortage and the Future

Nurse practitioners (NPs) and physician associates/physician assistants (PAs) continue to rank first and second, respectively, on the U.S. News & World Report 2023 Best Health Care Jobs list. On the overall 2023 Best Jobs list, NPs and PAs ranked second and fourth, respectively, underscoring the continued importance of these health care professions especially as the repercussions of the COVID-19 pandemic continue to affect the health of Americans. 

This is the second year in a row that NPs have been the number 1 job in health care in the U.S. News report, said April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, president of the American Association of Nurse Practitioners (AANP). “During the past few years, nurses have gone above and beyond, they are seeking advanced education and training, they are nationally board certified to care for their patient population in all practice areas, and they are providing much-needed access to care in all regions of this country,” Dr Kapu said in an interview.

“The 2023 report marks the sixth straight year that the PA profession ranked in the top 5 overall careers,” said Jennifer Orozco, DMSc, PA-C, DFAAPA, American Academy of Physician Associates (AAPA) president and chair of the board. “Just as in the 2022 rankings, the PA profession remains the number 2 top health care job. These high rankings year after year demonstrate the value PAs bring to patients and a modern health care system and underscore how our profession will continue to shape the future of health care.”

Average Salary for NPs and PAs

The median salary for NPs is $120,680 and for PAs is $121,530, according to the US News report. These estimates are similar to those found in the 2022 Clinical Advisor Salary Survey, which showed average salaries of $117,054 for NPs and $124,182 for PAs. 

High Rates of Job Security Found for Advanced Practice Providers

The unemployment rate is low among both professions — 0.4% for NPs and 1.2% for PAs — and these professions were ranked number 1 and 4, respectively, on the list of careers with the most job security, according to the U.S. News report. Both professions showed above-average opportunities for advancement and salary.

The NP field is the fastest-growing occupation according to the US Bureau of Labor Statistics, which projects that employment will grow by 46% between 2021 and 2031 with an additional 112,700 NP jobs expected to be added over the next decade. The NP profession grew by 9% between 2021 and 2022 with 355,000 NPs currently in practice, Dr Kapu said.

The large growth projected for the next decade underscores the lack of access to care that spans across the country and in all fields, but especially mental health, Dr Kapu explained. With more nurses set to retire in the near future, there is a push toward increasing interest in the NP profession, increasing funding for nursing education, enlisting more nurse educators, and reducing other barriers to education, Dr Kapu said. “We are seeing growth, but we need to do more,” she said.

For PAs, employment will grow 28% between 2021 and 2031 with approximately 38,400 jobs added, which is much higher than the 5% average growth of all occupations, Dr Orozco noted.

The PA profession was also number 4 on the Best STEM Jobs list and the STEM field is rapidly expanding across the US, Dr Orozco explained. The Department of Labor estimates that STEM occupations will grow 10.8% between 2021 and 2031, she added. Nurse practitioners also ranked highly on the Best STEM Jobs list, coming in at number 2.

“At a moment when our country is faced with significant challenges, including the Great Resignation, an uncertain economic future, a significant health care workforce shortage, a growing aging population, and a greater prevalence of chronic illness, our profession has been recognized as one that continues to rise to the occasion,” said Dr Orozco.  

“With more than 99 million Americans without adequate access to primary care and more than 158 million Americans without adequate access to mental health care, PAs are an essential part of today’s modern health care system to ensure that all patients have access to high-quality, patient-centered care,” Dr Orozco said.

How Are NPs and PAs Managing Stress and Burnout?

The overall job rankings take into consideration a number of factors including salary, projected growth, and stress level/work-life balance. Both the NP and PA professions ranked above average in stress level, as did nearly all of the professions on the Best Health Care Jobs List. Dr Kapu said that while stress levels for advanced practice providers may be higher than jobs in other fields, NPs tend to have high rates of satisfaction with their careers.

“We have continued to see higher than normal stress levels across all health care professions over the past 3 years,” Dr Kapu said. And while burnout is still prevalent among APPs, “we are also seeing studies showing that there are solutions and mitigating factors to burnout including having a healthy work environment in which NPs have autonomy, practice to the full extent of your education and training, have avenues for professional development and advancement, and feel respected for what you do, that your voice is heard, that there is a culture of safety, and that you are a stakeholder in critical decisions that affect your practice.”

Access to readily available mental health services without stigmatization is another strategy to counteract stress and burnout among health care workers, she said. The AANP offers its members immediately accessible free mental health services through its NPower program.

Modernizing Health Care Laws

“What can never be fully measured is how rewarding it is to be part of a profession that improves the health and well-being of patients every day,” Dr Orozco added. “However, we must continue to advocate on behalf of our patients by modernizing health care laws and regulations to ensure that PAs can practice to the fullest extent of their education, training, and experience.”

Twenty-six states and the District of Columbia have modernized state laws so that NP’s licensure is equivalent to their education and training, according to the AANP. States with the highest rankings for health care outcomes are also those states that have granted NPs full practice authority, Dr Kapu explained. In those states that still have restricted practice barriers to care such as mandated collaborative contracts with physicians to conduct retrospective chart reviews at the end of each month, the fees for those mandated contracts are unregulated and can be “enormous barriers” for NPs to be able to practice because of the high cost.

“We need all states to modernize their laws so the NPs can practice to the full extent of their education and training,” Dr Kapu said.

This article originally appeared on Clinical Advisor