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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Nurse Practitioner Rated as the 2nd Best Job in the USA. Really?

Happy nurse at hospital

It appears the U.S. News and World Report just released its 2023 “Best Job Rankings” and guess what? Being a nurse practitioner was ranked as #2 in the country for “best job” overall and ranked #1 as the “best job” in healthcare, followed by physician assistants as #2 (which was ranked #4 as “best jobs” overall just FYI). I am not debating the fact that being a nurse practitioner is a great job… it is a great job, to an extent… Why do I say to an extent? Because it is multifactorial:

Do you work in a setting that you are passionate about?

Are you being compensated fairly? (most NPs are not)

Do you truly feel autonomous?

Are you professionally fulfilled?

Many nurse practitioners absolutely love their job because they meet the criteria above. On the other side of the coin, many nurse practitioners ARE NOT fulfilled because they are being screwed over one way or another… and usually in more than one way:

Most nurse practitioners are grossly underpaid for what they produce.

The nurse practitioner market is getting more and more saturated, which is leading to fewer and fewer jobs, which leads to being stuck in a position you are not that thrilled about. Add physician assistants into the mix and it gets worse.

There is an obvious career ceiling being a nurse practitioner.

And ultimately, many nurse practitioners do not feel fulfilled or autonomous working for some huge corporate healthcare conglomerate and being forced to practice a certain way because of insurance, Medicare, and Medicaid restrictions.

Regardless, I was curious to see how these “best job” scores were calculated because from what I see and hear on a daily basis, being a nurse practitioner can be tough when schools are pumping out 25,000+ new graduates a year which results in market saturation and ultimately stagnant salaries and high unemployment amongst new graduates. So, I looked it up and to summarize their scoring system, they scored jobs based on the following metrics:

Median salaries.

Unemployment rate.

10-year growth volume and percentage.

Future job prospects.

Stress level.

Work-life balance.

I am not sure how they quantified a lot of this, but it appears to be based off “literature” reviews from the editors and writers. Alright… did you scour the online nurse practitioner communities and see how many nurse practitioners are struggling? I doubt it… So, keep in mind this article will be biased towards certain professions and I am not sure why they picked the ones they did to promote.

Regardless, when you look up MEASURABLE statistics as stated in the article, then being a nurse practitioner SOUNDS like a great job.

According to the article, you can make $120,000 or more a year, the unemployment rate is low, and the growth prospects look fantastic! But I am confused, because in the real world it isn’t that peachy.

Nurse practitioners were making $120,000 a year 15-20 years ago… Where is the wage growth?

The unemployment rate is low…. Really? Where were these numbers picked from? Because I hear on a daily basis about new graduates AND seasoned nurse practitioners unable to find work… Even if the unemployment rating was true, a large number of nurse practitioners are underemployed. I know too many nurse practitioners who are still working as a registered nurse because they aren’t paid enough as a nurse practitioner or can’t find anything beyond a part-time job doing Medicare home risk assessments… Also, RN pay sometimes is even BETTER than NP pay… A very sad state of affairs.

Growth prospects are NOT high… The market is saturated, and jobs are hard to come by. Oh, but the Bureau of Labor Statistics predicts a higher demand for healthcare workers (IN GENERAL, NOT JUST NPs) because of an aging population. Got it… That might be the case for the RN or CNA, but where are the 25,000+ nurse practitioners (not even including the physician assistants) graduating every year going to work? Many can’t even find a job NOW… But they will in 10 years? On top of the 300,000 additional nurse practitioners put into the market over a decade? Got it, makes sense…

Again, I AM NOT SAYING being a nurse practitioner is not a great job. It is a great job, but I fear for the future of our profession amongst an ever-increasing saturated market. Articles like this ONLY feed into that market saturation further as people read articles like this AND more and more people are desperate to find six figure jobs AND becoming a nurse practitioner is relatively simple to do as long as you are willing to put the time into it.

I have written about how you really can’t do anything about market saturation before, so I am not going to explain that as I still hold my position about it: there really isn’t much we can do about nurse practitioner market saturation, it IS going to continue and likely worsen…

Our market WILL become more saturated, and it WILL become more difficult to find a DECENT paying job. For heavens sake, I saw a job posting the other day for $30 an hour for a nurse practitioner… ARE YOU KIDDING ME? How is even $120,000 a year even reasonable for what we produce? A productive nurse practitioner at a general medical practice or urgent care should EASILY produce $600,000+ in revenue a year… Nurse practitioners in the ER (or busy urgent care) are producing a $million+ in revenue and are compensated a whopping $60 an hour for their time and efforts. Whoopdie do. Thanks for being so generous oh healthcare administration and fat overpaid CEO, I praise you! *insert eye roll*

Listen, if you are a nurse practitioner reading this then you need to begin taking some steps to SECURE your position and financial footing in the years to come. First off, you better be investing your money and saving for the future, but that is not the point of this article. So, you have three options:

  1. Find a job that brings you fulfillment that pays you fairly in your area.
  2. Find a job that brings you fulfillment that pays you fairly well in other places (if you are willing to move).
  3. Start your own practice.

Options one and two require you to be DEPENDENT on an employer. There are still some solid employers out there (I am one), but your job ultimately is not secure. When times get tough, lay offs start. Also, when healthcare administration wants to fatten their pockets more, then they go to reducing salaries and positions first. If you are sitting on a comfortable job making what you deserve to be paid ($160,000+ a year), then don’t get too cozy… There is a new grad right around the corner who will work for $50 an hour because they are desperate to get off the floor working as an RN. This is true, it happens more than you know.

That leaves us with option three, and for the nurse practitioner entrepreneurs reading this, they will agree: owning your own practice as a nurse practitioner is the ONLY way to earn what you are worth. Outside of the financial incentives of owning your own practice, it is the ONLY way to truly be autonomous and live a life on YOUR terms. Plus it brings you massive security.

You are more secure owning your own practice than working for others. No question about it because you are in control, and you make the rules. Has a manager or healthcare administrator ever made a decision that you thought was just dumb? Yea, we have all been there and that doesn’t happen IN YOUR BUSINESS.

If you want to earn more money, you see more patients. If you are content with your time commitment, then you put on the breaks and cruise. The amount of money you can earn based off your time commitment in a business is multiple times more than you will ever make being employed. I was able to pay off all my debt and my mortgage because of my business… not a job.

Also, starting and operating your own business is just FUN. Sure, it can be stressful during the startup phase, but once it is up and running, it is just fun. I can see my patients how I want to see them and talk with them how I want to talk to them. My initial appointments last an hour, and we are NOT on a time constraint because I have to see 3-4 patients an hour to get the billings up in the standard employed clinic model.

I am going to end the article with this:

I pay myself a salary of $180,000 a year from my men’s health practice. I work 4-6 hours a week. I make more than a neurosurgeon. When you factor in the amount of time I put into my practice and how much I am paid, it comes out to almost $700 an hour. Good luck making that in an urgent care. Additionally, my business is SECURE. We continue to grow and the demand for the services I offer are only increasing. Plus, I don’t have to deal with the headaches of insurance because I am 100% cash only AND I actually enjoy the work. I don’t dread it like when I worked in an urgent care seeing a ridiculous number of patients

So, if U.S. news wanted to use my situation for their article, then yes: being a nurse practitioner ENTREPRENEUR is the best job in the country. But unfortunately, I am going to disagree that being an employed nurse practitioner is the 2nd best job in the country… It just isn’t in the current healthcare climate in this country. I know happy bartenders, electricians, car salesman, and marketers who make the same (or more) as nurse practitioners with a fraction of the stress and hours they put into their job… Sad, but true… Why weren’t those professions included in this article? I will let you make that determination.

4 Responses

  1. I agree with you Justin, in that being a NP is a great job to a certain extent. For my first job, as a NP I started out working for a small practice run by two greedy people who started off ok and then during the pandemic tried to assign me upwards to 30 patients per day. I also had terrible benefits and paid around 1800/month for health insurance for myself and husband. Took them 4 years to give me a raise and I only received it after threatening to quit. They later responded with my plea for more help with “can’t right now” the business was then sold to a venture capitalist. I’m working for another company now who solicited my help a number of years ago. They are decent people with good front office support staff but the pay for my level of risk, time and investment is not spectacular. I made more as a ED RN with much better benefits. Additionally, they do not furnish any sick time, health benefits or CEU time. They advertised health and 401 benefits when looking for additional people but later pulled the ad when I requested these benefits a second time.
    in my opinion, owning your own business is the way to go. I have started my own business and taking my time, learning from your pod casts and CEU classes as I go. I already have a number of patients who followed me from the first job so am off to a decent start.
    thank you for all of your guidance!

    1. Perfect! At least you saw the light and are doing your own thing. It is a great job if you are independent, but I don’t think it is a great job if you are employed…

  2. I’d love to have been able to make anything close to $120,000 as an NP. The most I have ever been paid is less than $90,000 a year working around 60 hours a week. It was awful. I saw this and thought…I bet they didn’t actually talk to working NP’s about what it is really like. Thank God I found Justin and his guidance because I can’t even get a job around my area. Was advised the hospital here could not afford me and they were going to offer me less than I made an RN working agency….I felt insulted to say the least. 20yrs experience and a DNP. So, I am so blessed to have been able to get my own business started and doing well so far! Thank you a million Justin!

    1. Rose, you are not alone in terms of getting screwed over as an NP. Luckily though, you saw the light and ventured on your own. So well done, I applaud you. You have done more than what most NPs will ever do.

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