There is no doubt that nurse practitioners and physician assistants are in demand in the US workforce. A 2013 survey of more than 300 large multispecialty health care organizations indicated that about two-thirds of them had increased their NP/PA workforce and were projecting additional hiring in the next 12 months. Also of note: 31% of these organizations reported having an NP/PA in an administrative role (an increase from 20% in 2012).1
But along with being in demand, our jobs have become increasingly demanding. Health care is changing, not least because of a shortage of primary care physicians, baby boomers increasing their consumption of health care, an increase in chronic disease care, and the growing complexity of health care management. Historically, large studies by our national professional organizations have indicated that NPs and PAs are predominantly satisfied with their role and their future professional prospects. But is that still the case today?
With that question in mind, a quasi-scientific nationwide survey was conducted at the behest of NP Editor-in-Chief Marie-Eileen Onieal and myself. We wanted to determine whether PAs and NPs are satisfied with their work and the state of their profession. This survey, fielded over a two-week period in February, involved a self-selected sample derived from an invitation to almost 100,000 PAs and NPs via the Clinician Reviews mailing list, as well as a posting on the Web site. It should be noted here, for my statistician friends, that this sample may not be representative of the population—but it does create the opportunity for discussion. People who respond to these types of surveys tend to feel strongly, one way or another, about the issues; this questionnaire was no exception.
A total of 240 clinicians participated: 145 NPs (60%) and 95 PAs (40%). The majority (88% of NPs and 86% of PAs) reported being in clinical practice, and 29% of NP respondents and 45% of PA respondents indicated that they have been in their profession for more than 20 years.
Demographically, more women than men participated (NPs, 94%; PAs, 58%), 71% of respondents were between ages 50 and 69, and almost 90% were white. The last item begs the question of the professional satisfaction of nonwhite NPs and PAs. As in other medical fields, the NP and PA professions do not currently emulate the diversity of the US population—which is something we should strive for (perhaps a topic for a future editorial).
Most respondents had “very positive” feelings about their profession (NPs, 73%; PAs, 65%), and many reported feeling “somewhat positive” (NPs, 23%; PAs, 28%). Only 4% of NPs and 7% of PAs expressed negative feelings about the current state of their profession. Perhaps not surprisingly, the majority of both NPs (58%) and PAs (65%) also indicated feeling “very positive” about the future of their profession. Overall, 66% of NPs and 60% of PAs said they would choose the same profession if they had the opportunity again.
So what, if any, are the drawbacks to being a PA or NP? Well, with regard to workload, participants most commonly endorsed the response that they were working at full capacity but not overextended or overworked (NPs, 43%; PAs, 51%), and the majority felt they were adequately compensated for their work (NPs, 69%; PAs, 73%). However, a significant portion of the remaining respondents had less positive feelings on both subjects; Table 1 and Table 2 provide full data.
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