'Life Is Good' for Nurse Practitioners, Survey Finds

Megan Brooks

October 11, 2013

Nurse practitioners (NPs) are far happier in their jobs than physicians, but most say they have no time to see more patients or take on more duties, suggesting they may not be able to help ease the physician shortage.

"The hope is that NPs can help address prevailing physician shortages. However, there are already signals that NPs themselves are overextended," Margaret Crump, chief operating officer of the American Nurse Practitioner Foundation, said in a news release.

The findings stem from a survey of 222 NPs who attended the 2013 annual meeting of the American Association of Nurse Practitioners, held in Las Vegas, Nevada, in June.

The survey was conducted by Staff Care on behalf of the foundation.

"Life Is Good"

All 222 NPs surveyed said they have positive feelings about being an NP: 99% are optimistic about the future of their profession, 96% said they would choose to be an NP if they had their careers to do over, and 97% said they would recommend becoming an NP to their children or other young people.

Why are NPs so happy in their jobs? "Because all signs are pointing up for them," Michelle Hoogerwerf, vice president of marketing for Staff Care's Advanced Practice Division, told Medscape Medical News.

"Their clinical autonomy is increasing as more states allow them to practice a full scope of medicine unsupervised by other disciplines. Their importance and prestige is rising as more hospitals, health systems, and accountable care organizations...move to team-based care, in which they play a big part. Their incomes are going up, and they are getting job offers every day. So life is good," she explained.

Hoogerwerf notes that NPs are considerably more satisfied in their profession than physicians, registered nurses, and other healthcare professionals surveyed in the past. Many physicians have seen their clinical autonomy and their reimbursement declining in recent years, whereas many NPs have experienced just the opposite trends in their practices, leading to comparatively higher satisfaction rates, she said.

Supply and Demand

Of the 222 NPs surveyed, 75% think there is a shortage of NPs; only 23% said there is an adequate supply. More than 80% of NPs said they are currently overworked and overextended in their practices or are at full capacity. Only 19% said they have time to see more patients and take on more duties.

It's estimated that there are more than 155,000 NPs practicing in the United States today, with an estimated 11,000 completing training each year. Close to 90% of NPs practice in the primary care setting, where physician shortages are highest.

When asked what they plan to do in the next 1 to 3 years, 63% of NPs said they will continue in their current practice style, 10% said they would work independently, 10% said they would work in temporary (locum tenens) practice, and 12% said they would work part-time.

NPs surveyed reported they see an average of 17 patients per day and earn an average of $95,800 a year.

A potential limitation to the survey is that it was self-selecting and only included NPs who attended the Las Vegas meeting, meaning it may not reflect the experiences and opinions of NPs who did not attend the meeting or who chose not to participate in the survey.

NPs to the Rescue?

Hoogerwerf said that although it is difficult to determine precisely how reform and ACOs will drive demand for medical services, "it is clear they will boost demand considerably, particularly in primary care."

"If you assume that each of the 30 million newly insured will visit a physician 2 times more a year than they did before they had insurance (a conservative estimate given the pent-up healthcare needs of many), you will have 60 million additional patient visits that will need to be handled a year," she explained.

"A primary care physician handles about 4000 ambulatory encounters a year, so that works out to a need for 15,000 additional primary care physicians just to handle additional visits generated by the newly insured. Many policy experts expect that NPs will take up the slack, and in some cases they will," Hoogerwerf said.

However, the current survey shows that most NPs say they already are either "at full capacity or are overworked and overextended. It may be a mistake to think that NPs will ride to the rescue, because, like physicians, they too are in increasingly short supply," she warned.

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