Everyone is in NP school !

shibaowner, MSN, RN, NP · Aug 9, 2017

Damn close.
"The primary care NP and PA workforces are projected to grow far more rapidly than the physician supply.
The supply of primary care NPs is projected to increase by 30 percent, from 55,400 in 2010 to 72,100 in 2020. The supply of primary care PAs is projected to increase by 58 percent, from 27,700 to 43,900 over the same period.
Assuming that NPs and PAs provide the same proportion of services in 2020 that they did in 2010, the combined demand for NPs and PAs would increase by only 17 percent. If NPs and PAs are used to provide a greater proportion of primary care services, their projected demand will be higher."
From:
Projecting the Supply and Demand for Primary Care Practitioners Through 22 | Bureau of Health Workforce

Thank you for the link. I reviewed the information and still fail to see that there are "17 millions new NPs in the graduation pipe line."

Let's take a look at what this source actually said:

1. "If today's system for delivering primary care remained fundamentally the same in 2020, there will be a projected shortage of 20,400 primary care physicians."

2. "The supply of primary care NPs is projected to increase by 30 percent, from 55,400 in 2010 to 72,100 in 2020. The supply of primary care PAs is projected to increase by 58 percent, from 27,700 to 43,900 over the same period."

3. "Assuming that NPs and PAs provide the same proportion of services in 2020 that they did in 2010, the combined demand for NPs and PAs would increase by only 17 percent."

4. "Under a scenario in which the rapidly growing NP and PA supply can effectively be integrated, the shortage of 20,400 physicians in 2020 could be reduced to 6,400 PCPs."

5. "If fully utilized, the percent of primary care services provided by NPs and PAs will grow from 23 percent in 2010 to 28 percent in 2020. Physicians would remain the dominant providers of primary care, only decreasing from 77 percent of the primary care services in 2010 to 72 percent in 2020."

Basically, the article says that if NPs and PAs were utilized more in primary care, then the PCP MD shortage would be eased. I don't see anything in this article that states there is an oversupply of primary care NPs.

In addition, this article is only talking about primary care. Not all NP students are going into primary care. About half of NP students will go into acute care, psych, management, etc. "As of 2012, there were an estimated 154,000 licensed NPs in the U.S., 127,000 of whom were providing patient care. Slightly under half of those worked in primary care."

Where are the "17 millions of NPs in the pipeline?" I'm scratching my head here.

I am disturbed by what seems to be an almost gleeful expectation of the apocalypse for new grad NPs among some posters on this forum. That is doing a disservice to our profession as it may scare away talented candidates. We will always need excellent new grad NPs and RNs coming into the workforce.

There may be an oversupply of NPs in certain areas. This is a distribution problem, not a supply problem. There are many smaller cities and towns, inner cities, and rural areas that desperately need primary care providers. New grad NPs must be prepared to move in order to get their first job.

Perhaps there are too many NP students and schools, although I have yet to see anyone provide evidence of this, beyond anecdotal accounts. So what? Since we live in a capitalist economic system, the crap students will not get hired, so the crap schools will go out of business. The excellent new grads from good schools will get jobs. Problem solved.

After engaging in this dialogue thread, I would advise undergrad students to take Economics as part of their General Ed electives.

Projecting the Supply and Demand for Primary Care Practitioners Through 2

Owlgal · Aug 9, 2017

Thank you for the link. I reviewed the information and still fail to see that there are "17 millions new NPs in the graduation pipe line."
After engaging in this dialogue thread, I would advise undergrad students to take Economics as part of their General Ed electives.
Projecting the Supply and Demand for Primary Care Practitioners Through 22 | Bureau of Health Workforce
https://www.aacn.nche.edu/downloads/aacn-future-task-force/Inglehart-PC-Article.pdf

Best response ever!

Seriously, though. I've gone over to the NP Student forum and there are far too many "I didn't pass boards" threads. This blows my mind. I seriously want to know what schools these people are attending. At this level, anyone who is getting their MASTERS degree as a Nurse Practitioner should be qualified to pass boards. This isn't LPN school or an ADN program. Boards should filter out the one's who really shouldn't practice.

Of course, I go to a different forum that is geared mostly towards doctors and I see all sorts of posts about how individuals have failed out their first year of community college and are hoping to go back to school and get into medical school -- if its that easy to get into medical school, I might have tried that route.

Jules A, MSN · Aug 9, 2017

At this level, anyone who is getting their MASTERS degree as a Nurse Practitioner should be qualified to pass boards. This isn't LPN school or an ADN program. Boards should filter out the one's who really shouldn't practice.
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So I'm not the sharpest knife in the drawer but I personally found the two NP board exams I took embarrassingly easy. They were largely policy and cultural competency focused with minimal diagnostic or medication questions.

shibaowner, MSN, RN, NP · Aug 9, 2017

So I'm not the sharpest knife in the drawer but I personally found the two NP board exams I took embarrassingly easy. They were largely policy and cultural competency focused with minimal diagnostic or medication questions.

Good for you! It appears you took the ANCC. The AANP only has clinical questions, which is the exam I took. AANP has about 85% pass rate (varies by specialty), so it does seem to weed out unprepared test-takers.

Atl-Murse · Aug 10, 2017

17 million number used is to show the extremely high number in the pipeline. Dont take that numbet laterally. Maybe I used the 17 trillion if that will help you. Every number/percentage used in the OP is not lateral.

shibaowner, MSN, RN, NP · Aug 10, 2017

17 million number used is to show the extremely high number in the pipeline. Dont take that numbet laterally. Maybe I used the 17 trillion if that will help you. Every number/percentage used in the OP is not lateral.

This type of exaggeration and imprecision reduces the credibility of your argument.

Jules A, MSN · Aug 10, 2017

This type of exaggeration and imprecision reduces the credibility of your argument.

No need to be so concrete. It was nothing more than an obvious hyperbole, which I happened to enjoy because it is exactly how it feels to me. Consider lightening up a bit your constant barrage of condescending bullet points addressing every word members post takes any fun out of interactions.

umbdude, MSN, APRN · Aug 10, 2017

I don't think everyone is in NP school. That is not the case at my hospital. If you work at a large research hospital, there might be a selection bias since many people work at these hospitals in order to boost their resumes for further education. NP jobs will still be there, but you might have to compete harder to get jobs.

shibaowner, MSN, RN, NP · Aug 10, 2017

No need to be so concrete. It was nothing more than an obvious hyperbole, which I happened to enjoy because it is exactly how it feels to me. Consider lightening up a bit your constant barrage of condescending bullet points addressing every word members post takes any fun out of interactions.

When we are discussing the future of our profession, I believe it is important to have our facts in order. In addition, when I see posts claiming that there are too many NPs and NP students, I am concerned this will discourage talented individuals from pursuing an NP career. Therefore, I don't feel this is the place for hyperbole.

guest769224 · Aug 10, 2017

when I see posts claiming that there are too many NPs and NP students, I am concerned this will discourage talented individuals from pursuing an NP career.

As it should. With a profession so prone to over-saturation already occurring and with a potential for worsening, those "talented individuals" deserve the right to know that they may well encounter difficulty obtaining employment upon completion. Should they find a job, it may present with subpar pay and benefits. Many posters have been on this forum long enough to see that the job situation apparently isn't improving. As it was with lawyers, supply overshadows demand, and salaries drop. I have seen many, many posts on these forums about NP's taking jobs for $60-70K/year, because that's "all that's available", and there are too many NP's in their area, so they can move, or just accept such salaries.

There is a lot of potential for good, lucrative opportunities for NP's in the right places, but don't kid yourself, some areas are not nearly as fortunate, particularly as fortunate as the state of California that caters more-so to NP's because of the strong nursing union presence in the state.

Potential career changers absolutely deserve to know the facts. Barrier to entry protects a profession. Take nurse anesthesia for example. The AANA has set high standards and requirements. NP schools very, very rarely down turn candidates. Yet, PA schools do quite often. My frustration lies with how easy it is to become an NP. That needs to change.

shibaowner, MSN, RN, NP · Aug 10, 2017

As it should. With a profession so prone to over-saturation already occurring and with a potential for worsening, those "talented individuals" deserve the right to know that they may well encounter difficulty obtaining employment upon completion. Should they find a job, it may present with subpar pay and benefits. Many posters have been on this forum long enough to see that the job situation apparently isn't improving. As it was with lawyers, supply overshadows demand, and salaries drop. I have seen many, many posts on these forums about NP's taking jobs for $60-70K/year, because that's "all that's available", and there are too many NP's in their area, so they can move, or just accept such salaries.
There is a lot of potential for good, lucrative opportunities for NP's in the right places, but don't kid yourself, some areas are not nearly as fortunate, particularly as fortunate as the state of California that caters more-so to NP's because of the strong nursing union presence in the state.
Potential career changers absolutely deserve to know the facts. Barrier to entry protects a profession. Take nurse anesthesia for example. The AANA has set high standards and requirements. NP schools very, very rarely down turn candidates. Yet, PA schools do quite often. My frustration lies with how easy it is to become an NP. That needs to change.

I disagree with your post based on the facts, as well as my understanding of professional services.

1. There are plenty of NP jobs! I have yet to see a single piece of EVIDENCE (not anecdotes) regarding a glut of NPs. Every news article I see indicates the demand for NPs will continue to increase. Everyone single one of the new grad NPs from multiple specialties from my school found a GOOD job within a few months (that's my anecdote).

2. Please do not confuse supply with distribution. You are absolutely correct - there are great opportunities "in the right places." That would be true of any profession. There is an ACUTE shortage of primary care providers in underserved areas like inner cities, secondary and smaller cities and towns, and rural areas. The military is also always looking for good NPs and RNs. This geographic demand and distribution issue is true of any profession. If I am a high tech genius, then my best bet is to live in Silicon Valley, Austin TX, Seattle WA, Wash DC, etc. If I am a newly minted lawyer, my best bet is NYC, LA, SF, Wash DC, etc. Anyone who is in a profession, and is serious about their career, is prepared to move at least once. If an NP wants to make top $ and is wiling to move if necessary, there are plenty of good jobs!

3. Certain NP specialties, like PMHNP, are also in very high demand. The VA and military are also eager to hire NPs with solid women's health experience.

4. Give possible NPs the facts about our profession? Absolutely. Unduly scare them off? No. It is absolutely wrong to discourage talented people for a few reasons. I had a previous career in high tech management consulting. We only hired the best and brightest. However, consulting is a very stressful career with high burnout. Recruiting was a top priority! Every Friday, consulting firms have all day long interview of both experienced and new grad candidates. We were constantly going to job fairs. The top law firms do the same - they are always recruiting the best talent, both experienced and new grads. Stressful professions must replace practitioners lost to attrition, and the successful practices (organizations) are also growing and need more good people. We need to cast our nets wide to ensure we get the best people.

5. "NP schools very, very rarely down turn candidates." Really? So I guess just anyone can get into the NP programs at Hopkins, Yale, U Penn, UCSF, UCLA, etc?

6. Are there some crappy NP schools out there? Yes. However, no one is forcing people to go to these schools. And most certainly, no one is forcing employers to hire graduates of these schools. We still have a market-based economy, so if employers only hire good NP candidates from good schools, the crappy schools will go out of business. For profit schools (in general) are facing increased scrutiny and some are closing down.

7. We are also seeing the results of demographics. The surge in college and nursing students is in large part due to the children of the baby boomers (echo boom) entering and graduating from higher education institutions. This echo boom is almost done with school now. Based on demographics alone, we are seeing colleges closing. The same thing happened after the original baby boomers passed college age - many colleges shut down.

8. With regard to barriers to entry:

8.a. It is hard to get into a good NP school, and to get through school and graduate.

8.b. Graduates of NP school must take a license exam - the exams do not have a 100% pass rate. The ANCC FNP pass rate is 75% and the AANP FNP pass rate is 81%. So, it appears these exams are weeding out a reasonable number of unprepared candidates.

8.c. Crappy NPs from crappy schools are probably much less likely to be hired.

8.d. The MD approach to med school has resulted in a shortage of primary care providers, an oversupply of specialists, and skyrocketing med school tuition. I hardly see this as an example to emulate. Even so, there are now foreign med schools with lower standards that produce US-based doctors.

8.e. I think nursing's more flexible career development approach is an advantage. There are many wonderful NPs and CRNAs that started in community college or diploma programs, and worked full time while completing their BSN and then graduate studies. This makes it possible for people of limited financial means to enter a great profession without incurring a boatload of student debt - the average new MD has $300,000 in student debt. That flexibility also gives us the opportunity to be more inclusive and diverse in our NPs.

In conclusion, I strongly believe our profession is best served by encouraging the best and brightest to become RNs and NPs, and also by providing potential professionals with solid information on the best schools and how to maximize their career growth. Overtime, market forces will solve any maldistribution and quality issues.

lwsoccjs · Aug 10, 2017

If we are really going to pick apart every word someone says here is a fun one. 81.6% to be exact and that is only first time test takers. No where do they disclose how much we can cram the second go around and pass just saying.