FNP Oversaturation

djmatte, ADN, MSN, RN, NP · May 1, 2018

Dranger said:
No, not in WA

So why on earth would you work for someone willing to pay you less when you can work for yourself and get full reimbursement?

guest416560 · May 1, 2018

If I'm billing the insurance companies at 85% of what a MD does then I expect to be paid accordingly. Unfortunately most NPs are not because they are ignorant on how to negotiate or just refuse to do so.

If a family doc MD brings home $250k then I should be paid $212,000 for the same type of work.

socal1 · May 1, 2018

It all comes down to having the MD behind your name, doesn't matter if there is an NP or PA doing the same thing an MD is, the public believe that you still aren't on that level.

Dranger · May 1, 2018

djmatte said:
So why on earth would you work for someone willing to pay you less when you can work for yourself and get full reimbursement?

I am an ACNP student, there is no working for yourself in the inpatient world obviously. There is such a flood of new grads who just feel special wearing a white coat and calling themselves a provider that they will lap up any job available. The supply is gluttonous and the salaries reflect that.

Jules A, MSN · May 1, 2018

socal1 said:
It all comes down to having the MD behind your name, doesn't matter if there is an NP or PA doing the same thing an MD is, the public believe that you still aren't on that level.

Please consider that a NP or PA is actually not on the MD level with regard to depth of education and knowledge.

FullGlass, BSN, MSN, NP · May 3, 2018

FNP2B1 said:
If I'm billing the insurance companies at 85% of what a MD does then I expect to be paid accordingly. Unfortunately most NPs are not because they are ignorant on how to negotiate or just refuse to do so.
If a family doc MD brings home $250k then I should be paid $212,000 for the same type of work.

I have mixed feelings about NPs demanding pay parity with MDs or large increases in their pay.

In favor of your position, I appreciate paying NPs based on the value they deliver. Oregon has moved strongly in this direction.

On the other hand, increasing NP pay dramatically will decrease demand for NPs. It also doesn't make sense to do this in states without full practice authority. NPs do not get 85% of the education and training that MDs do.

Interesting discussion.

Polly Peptide, BSN, MSN, RN, APRN · May 5, 2018

FullGlass said:
I have mixed feelings about NPs demanding pay parity with MDs or large increases in their pay.
In favor of your position, I appreciate paying NPs based on the value they deliver. Oregon has moved strongly in this direction.
On the other hand, increasing NP pay dramatically will decrease demand for NPs. It also doesn't make sense to do this in states without full practice authority. NPs do not get 85% of the education and training that MDs do.
Interesting discussion.

Increasing NP pay will increase their SUPPLY...not their demand. Unfortunately.

I am kind of with you, though, on ambivalence about increasing pay (significantly, at least). While I think the current pay is too low, I also think if we increase it too much, we defeat one of the reasons we can advocate for NPs' ongoing position as healthcare providers. If we are paid as much (or close to) doctors, why do they need us? Beyond the fact that med schools aren't pumping out docs fast enough.

I believe in an appropriate balance. Pay that reflects the responsibility and work, but that doesn't price us out of the market. There are a LOT of factors. I do think that we are flooding the market with far too much supply, thus destroying our (using "our" loosely...I am not an NP, yet) ability to negotiate. That and generally we have a "comparison" problem - basing NP pay on former RN pay, which frankly, should be irrelevant. As others have said, it shouldn't be viewed a "raise" based on "progression."

I'd like to interject some important stats into this conversation.

Based upon the HRSA Health Workforce primary care provider supply/demand study done in November 16, as of 2013, there were notable shortages of NPs/PAs in California, New Jersey, Illinois, Ohio, and Michigan (with California having a shortage of more than 2,000).

In 2013, TN had an oversupply of more than 1,000 NPs. By 2025, NO state is anticipated to have a shortage of NPs. NONE.

Fortunately...there will still be a few with PA shortages. As well, there will still be a PCP shortage, unless the med schools do something (and they are). Of course, legislation will have to change to allow NPs/PAs to fill in the blanks.

Point is...this is not just a "feeling" or gloom and doom on a website. It is happening, unfortunately. Whether "everyone" will realize it and it will self-correct...who knows?

https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/primary-care-state-projections2013-2025.pdf

ProgressiveThinking, MSN, CRNA · May 6, 2018

AANP - NP Fact Sheet

23,000 new NPs were produced between 2015 and 2016. That's pretty insane. Why doesn't the AANP put a cap on that number in order to prevent the profession from shooting itself in the foot? Anesthesia has similar problems with 2400 graduates being produced each year, but not to the scale of NPs.

I was considering getting my FNP after CRNA school just to mix it up a little, but now I'm not so sure.

Polly Peptide, BSN, MSN, RN, APRN · May 6, 2018

Looking at the report I posted a little more closely, by 2025, it's expected that 35 states' NP supplies will exceed their demand by more than 50%. And that is at least 50% (ranging up to 250%). As I stated before, though there are a few states with shortages currently, it's not anticipated there will be within a few years. At all. PAs' will exceed demand by more than 50% in 30 states. As it stands right now, with the current environment, where we will have the shortfall is with docs.

lwsoccjs · May 6, 2018

ksisemo said:
Looking at the report I posted a little more closely, by 2025, it's expected that 35 states' NP supplies will exceed their demand by more than 50%. And that is at least 50% (ranging up to 250%). As I stated before, though there are a few states with shortages currently, it's not anticipated there will be within a few years. At all. PAs' will exceed demand by more than 50% in 30 states. As it stands right now, with the current environment, where we will have the shortfall is with docs.

Yes here are the highlights:

An excess of 42,000 primary care NPs in 2025.

projected deficit of 23,640 FTE primary care physicians nationally by 2025.

increase in primary care PA supply is expected to exceed the increase in demand, resulting in a national surplus of 19,710 FTE primary care PAs by 2025.

So anyone that tells me there is or will be a shortage is laughable at this time.

The playing environment will be totally different in a few years time. My guess is by 2025 if you aren't already an NP with experience you won't be hirable.

djmatte, ADN, MSN, RN, NP · May 6, 2018

lwsoccjs said:
Yes here are the highlights:
An excess of 42,000 primary care NPs in 2025.
projected deficit of 23,640 FTE primary care physicians nationally by 2025.
increase in primary care PA supply is expected to exceed the increase in demand, resulting in a national surplus of 19,710 FTE primary care PAs by 2025.
So anyone that tells me there is or will be a shortage is laughable at this time.
The playing environment will be totally different in a few years time. My guess is by 2025 if you aren't already an NP with experience you won't be hirable.

Also encouragement for those gainfully employed to make themselves indisposable within their organization.

lwsoccjs · May 6, 2018

djmatte said:
Also encouragement for those gainfully employed to make themselves indisposable within their organization.

Agreed. I'll also leave this link

https://www.aanp.org/images/documents/about-nps/npfacts2013.pdf

But for reference at that time they graduated 14,000 new NPs at 49% family. Now it's 23,000 at 61%. But people will tell me that saturation isn't going to be a problem?