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Physician Assistant, Nurse Practitioner Professions See Unparalleled Growth in Recent Years

Lately, PAs and NPs have been regularly ranked among the best jobs in the country — and it looks like it’s starting to catch on.

According to two separate reports released earlier this year — one from the National Commission on Certification of Physician Assistants (NCCPA) and one from Health Affairs — the number of people choosing to become an advanced practice provider is steadily increasing year over year.

Physician Assistant Growth

Between 2017 and 2018, the certified PA workforce grew by 6.6 percent, and the average PA salary grew by more than 12 percent over just four years. For the past five years, the number of people seeking PA certification has consistently grown, culminating in 158,438 active licenses in 2018.

According to the most recent data from NCCPA, the median salary for PAs is $105,000, and the mean salary is $110,59. The report also revealed that PAs working Alaska, California and Nevada have the highest median salaries at $125,000.

RELATED: This Newly Certified Class of PAs is the Most Diverse the Profession Has Seen

New York State has the most PAs in the country with 12,743, followed by California’s 10,078 and Pennsylvania’s 8,818. Surprisingly, several states had fewer than 1,000 practicing PAs, including Maine, Rhode Island and Montana. States that’ve seen the greatest increase in PAs in recent years were Rhode Island at 13.7 percent, Arkansas at 11.4 percent, Nevada at 11.3 percent and Indiana at 10.4 percent.

The report also found that slightly more than a quarter, 25.8 percent, of PAs practice in primary care, making it the most popular specialty, followed by surgery and emergency medicine. Roughly 80 percent of PAs practice in either a hospital setting or an office-based private practice, with about 40 percent in each.

Nurse Practitioner Growth

The report from Health Affairs, which pulls from U.S. Census data, looks further back than the NCCPA’s. It found that between 2010 and 2017, the NP workforce grew by 109 percent, from 91,000 to 190,000. For context, over the same time frame, the RN workforce grew 22 percent (from 2.5 million to 3 million) and physicians grew 9 percent (from 870,000 to 950,000).

RELATED: WATCH: An NP and Resident Get Real About the Difference Between Their Work

Most of this growth is in primary care, due to the shortage of physicians with this specialty, and in outpatient settings. Many NPs are choosing to practice in rural areas, the report finds, because these communities are the most in need of access to medical care. The Southeast, including Alabama, Kentucky, Mississippi and Tennessee, saw the biggest increases in the NP population.

Another reason for the explosion of NPs? A massive increase in the number of APRN educational programs, according to Health Affairs. In 2010, there were roughly 356, versus 467 in 2017. Now, roughly the same number of NPs are graduating each year as MDs.

In fact, the future growth of NPs — 6.8 percent between 2016 and 2030 — is expected to outpace PAs’ 4.3 percent. By 2030, there will be two NPs for every five physician; in 2016, there were less than one NP for every five physicians.

RELATED: These are 5 of the Biggest Problems with How Advanced Practice Providers are Compensated

Over the study period, NP wages increased by 5.5 percent.

What does this mean for RNs and hospitals?

The report also addresses how this unprecedented growth is affecting registered nurses. It estimates that 80,000 RNs have left their roles in recent years to pursue advanced practice education and training. One of the report’s authors, Peter Buerhaus, a professor of nursing at Montana State University, explained to Modern Healthcare that many are drawn to the increased autonomy and clinical knowledge.

What’s good for nurses, though, proves the opposite for their employers, who are battling an RN shortage. By 2022, the U.S. Bureau of Labor Statistics predicts there will be 1.2 million RN vacancies, largely in home care, long-term care, outpatient and rehabilitation. As a result, healthcare facilities, especially hospitals, will need to find more effective ways of retaining experienced RNs.

RELATED: How Much Does the Average Nurse Make? RN Wages Depend on Many Factors

If you’re considering pursuing additional education, there are several factors to consider. For those who’ve already earned a BSN, the journey to an MSN or a DNP can be relatively quick. For those with an ASN or LPN, the process will take longer. But the additional $30,000 a year (if not more) and more manageable hours can make it worth it, especially if your employer foots the bill.


2018 Statistical Profile of Certified Physician Assistants by State, National Commission on Certification of Physician Assistants (NCCPA).

Implications Of The Rapid Growth Of The Nurse Practitioner Workforce In The US, Health Affairs.

Nurse practitioner workforce doubles amid primary-care push, Modern Healthcare.

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