Number of NPs Has Doubled Since 2010, Will Continue to Rise

Between 2010 and 2017 the number of Nurse Practitioners (NPs) working in the US more than doubled, increasing from approximately 91,000 to 190,000, according to a new report published in Health Affairs. And this trend is set to continue: the National Bureau of Labor Statistics predicts that the number of NPs will grow by 28% over the next 8 years.

A growing number of RNs are taking steps to become certified NPs, an option they find attractive for a variety of reasons:

• NPs earn a substantially higher salary than RNs
• Online and distance-learning NP programs make it easier for working RNs to pursue a degree
• States passing relaxed scope of practice laws enhance NP autonomy
• The booming walk-in and retail clinic market offers new career options and entrepreneurial opportunities
• Mounting demand for NPs to fill the shortage of new physicians

NPs can earn an average of $30,000-$40,000 more than RNs, and as a career, NP is ranked #5 among US News and World Report’s 100 Best Jobs. In turn, the enticing prospect of a higher salary and increased autonomy is drawing a surge of RNs to enroll in online NP programs. The flexibility these programs provide makes it possible (with a little dedication) for RNs to study for their MSN or DNP while continuing to work part-time or even full-time, and without having to relocate in order to attend classes on campus. US News and World Report suggests that “the online format is also ideal for students who must tackle additional commitments – such as child or family care – on top of their work and class schedules,” and adds that such programs can usually be completed within 2 years.

The trend is being encouraged by the relaxation in scope of practice laws in many states, which allows NPs to take on more primary care duties without being supervised by doctors. Even in states that have not passed less restrictive scope of practice laws, NPs are still far more independent of physicians than RNs and have become key players in the booming market for walk-in and retail clinics. NPs often take the lead as practitioners and–where scope of practice laws permit–even run these businesses. Walk-in/retail clinics are particularly appealing to younger patients, who benefit (as do the clinics themselves) from the reduced cost of being treated by NPs instead of physicians.

The expanding NP population is also a case of supply rising to meet a growing demand. According to the American Association of Medical Colleges (AAMC), the United States will see a shortage of up to nearly 122,000 physicians by 2032. With an aging population to treat, nurses are rushing to fill the gap to meet patient needs. In 2018, US News and World Report cited a report finding that “between 2012 and 2016 visits to non-physician health care providers (nurse practitioners and physician assistants) soared 129 percent.” And the American Association of Nurse Practitioners (AANP) states that NPs are helping to fill the dearth of primary care physicians in both rural and non-rural locations.

In addition to offering lower cost healthcare, being treated by an NP has other attractions that involve the distinctive nature of the nursing profession. While physicians are likelier to focus on diagnosis and treatment, NPs tend to take a holistic approach that embraces patient education and inquiry into psychological and social determinants of health. The distinct form of interaction often leads to a higher level of satisfaction among patients, who appreciate what the AANP describes as NPs’ “unique emphasis on the health and well-being of the whole person.”

Despite a considerable amount of pushback from the AMA and other physician-led groups against relaxing scope of practice laws, it seems unlikely that the advancing NP trend will reverse itself. Doctors cannot meet the demand for more health practitioners—especially in rural and other underserved areas—and the walk-in clinic movement shows no signs of slowing down. Also, the economics of treatment by NPs exert a powerful appeal that is likely to stand firm against the efforts of opponents. To NPs, the impetus comes in the form of the greater earning power they enjoy, plus an increased independence in practicing. For patients, there is the inarguable benefit of paying less for quality healthcare while receiving a level of attention that nurses are specially trained to offer.