Will there be too many NPs?

Jules A, MSN · Aug 12, 2016

We are on-boarding two NPs currently at our practice. Both come to us with 2 years NP experience and both are VERY sharp. They were only RNs for just 2-4 years prior to becoming NPs. They are both very competent to handle pts. They ask questions, look things up, study on their own time, have great attitudes and will benefit our practice and pts.

This is always nice to hear and 2-4 years of RN experience isn't bad and way better than the NONE most schools are requiring now. I believe the subtle things I witnessed and learned to assess as a nurse were invaluable to me especially early on.

Goldenfox · Aug 13, 2016

It's a good question, and one that if people don't get overly opinionated about by post #4 it will be a major miracle!
There are several things that come into play here. First, on has to define the market that NPs are trying to work in. The market that fits for most NPs is the primary care market, which is in a fairly strong change state currently, and most would agree how it is going to look in 5 and 10 years from now is very difficult to gauge. What will be the provider mix? (DO/MD/PA/NP), How will the demand change due to ACA and other forces? These and other questions like them have made there be a wide variety of projections on provider demand and supply.
Secondly, one would then have to factor in how they see not only NP schools production, but also schools for PAs, and even MD/DO. Adjust those numbers for those going into specialties in each area since these may affect how many are competing for the primary care positions.
Third, consider changing legislation and reimbursement models and how that will affect the need for providers in each group again. This will likely affect the demand in certain states over the next few years.
I'm sure there are other major factors to consider that aren't coming to me off the top of my head, but once you factor all of that in at a national level, then as mentioned above regional markets, urban/rural considerations, and other factors will play a role in the local markets and how saturated they will become.
I hope that helps!
All of that is to say, that all predictions are guaranteed to be wrong, the only question is by what amount! Having said that there are some concerns:
- There are far more NP programs, producing far more NP graduates than in the past. All I can say about this is I'm glad I'm at the head of the curve instead of at the backend. I expect it will be harder for students entering programs in a couple of years to find preceptors and get that all important first job than it will be for today's students. However, I'm not convinced this will lead to further impacts on experienced providers (regardless of degree) as I think they will remain in demand for the foreseeable future (just my opinion, I don't have numbers or a forecast to back this up).
- There will always be pockets of over saturation of providers. About 10 years ago a friend of mine, and a DO in primary care decided to move to a trendy town. She had 5+yr of experience in a town about two hours away. She had met a new love and decided to relocate. She knew many of the other DOs in that town, found a practice and came to an agreement to work there. Turned in her notice to her current practice and moved. Turns out there were just alot of providers in the town, didn't matter that they were MDs, DOs, NPs, PAs, etc. There were too many. So as she went about trying to build a panel, she struggled. She ended up taking a job at a local ER and working there for a couple of years. It was not her choice, she didn't want to do ER work, but she did because it put $$ in the bank. She is now working on starting a practice again. There is a national shortage of PCPs, but that doesn't mean that she just needs to open the door and she will be inundated with patients! Each opportunity has to have a good business plan and part of that is identifying how you are fulfilling a different need than your competitors. She learned that lesson, and is actively marketing her practice more aggressively than she did last time. Hopefully that will help her succeed. Irregardless of saturation level, we as NPs need to do the same. Either in our own practice, or make sure we sign up with practices that understand this important business concept.
In conclusion, to answer the last question on your original post. No, I absolutely do not see NP as being fully saturated in 5 years. I also do not believe experienced NPs will have a significantly more difficult time moving from job to job by then. I do believe new grads will need to work to find jobs and if they do not have a strong network into the provider community it might be more difficult than it is now.

The ACA will not exist in 4 years, much less 5 or 10. Its not sustainable. The exchanges are all going broke, and the few existing ones are planning massive premium hikes later this year in order to survive into 2017. Most people will simply not be able to afford it. And as the costs continue to escalate the system will collapse under its own weight. It would take another multi-billion dollar bailout from the federal government to save it, and they are broke too. Health care will change once the money flow begins to dry up. Some of the larger cash-guzzling facilities will close. Jobs will be harder to get, and pay will not increase when there's a glut of healthcare workers out there for employers to pick and choose from.

We have it good now, but if our government goes ahead with the TPP/TISA thing later this year we will all also find ourselves facing serious competition from foreign professionals who are willing to do our jobs for a lot lower pay. TISA means that US employers can bring them in en mass on worker visas to replace American workers. That being said, its not just the new grads who should be concerned about the future...it's all of us---including the MDs and the PAs too!

guest769224 · Aug 13, 2016

We have it good now, but if our government goes ahead with the TPP/TISA thing later this year we will all also find ourselves facing serious competition from foreign professionals who are willing to do our jobs for a lot lower pay.

Highly doubt that.

Goldenfox · Aug 13, 2016

Highly doubt that.

You may doubt it, but that won't stop it from happening. Pay attention to what's happening in the world of politics right now. ACA, Medicaid, Medicare, the rules by which health insurance companies operate...all of it is dictated by the political winds---which are now blowing strongly in favor of globalism, open borders, and exploitation of cheap labor everywhere. If you're paying close enough attention then you may notice that neither of the two presidential candidates (one of whom will be the next president) is supporting health care in its current form, and they both have their own plans for sweeping changes to dramatically cut costs.

Pay attention also to the TPP and its TISA component. Both were kept secret from the American public (until only fairly recently) for a very good reason. No one at all is taking about them. Total silence from the media. The average American still has no clue (or care to know) what's in these documents even though they are now available for public viewing. Look them up. They clearly state that under TPP/TISA corporations will be able to use foreign citizens to fill their employment/hiring needs inside the USA or any other member country as they see fit, and the new trade agreement rules override the current sovereign immigration laws of the member countries. Violations go before an international tribunal that is set up within the guidelines of the TPP itself, so no US court will have jurisdiction over them. In other words, this is a new system of plutocrats who make up their own rules, supervise themselves, and decide for themselves whether what they do is appropriate or not. LOL.

We won't see or hear about a lot of this stuff until after the elections. And a lot of people are going to be very surprised when they see the changes that are coming.