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

The NP Market Saturation

JOBS JOBS JOBS! We have been hearing for years that the job outlook for nurse practitioners is growing strong. Nursing academia, nurse practitioner magazines, our credentialing boards, and various nursing websites (biased entities) continue to say:

“The job outlook looks fantastic and we need to increase enrollment to meet the future demands…”

“There will be vast shortages and all these Baby Boomers are going to need more primary care…”

“More people are getting health coverage and nurse practitioners need to be there to meet the demand…”

And blah blah blah…

So, lets pause here for a second and look at some actual numbers. Remember the whole “evidence based” thing we learned in school? So, the AANP reports that 23,000 nurse practitioners graduated in 2016 and 27,800 graduated in 2018. That is 4,800 more graduates than just a couple years prior. We now have a total of 270,000 NPs in the job market as of 2018. This increases every year…

The sheer number of graduates is frightening but now let’s look at what the United States Department of Labor’s Bureau of Labor Statistics (non-biased entity) has to say. The BLS reports that there were 240,700 advanced nursing jobs in 2018. Okay, so now we have a 30,000 job shortfall already because the AANP states there are 270,000 nurse practitioners. Remember though, this is ADVANCED NURSING jobs… so NPs, CRNAs, CNMs, etc… Not just NPs!

The BLS goes on to state that there will be a 26% increase in jobs over the next 10 years. We can expect 62,000 more jobs in the next 10 years. That sounds great! Wow that is a lot of jobs. The future is bright!

But hold your horses, don’t get to excited because it gets worse. If nurse practitioner programs continue to pump out 27,000 graduates a year over the next 10 years that will be 270,000 nurse practitioners entering the job market with only a projection of 62,000 new jobs being formed. That is a shortage of 208,000 needed jobs! Yes, there will be nurse practitioners retiring and leaving the job market, but I highly doubt there will be enough to offset this. Where are all these people going to work? Please tell me if you know! I would LOVE to know.

In 10 years there will be an estimated 540,000 nurse practitioners in this country based off current statistics and trends. The actual number will likely be higher. If our population stays stagnant and this number remains the same, that means there will be 1 NP for every 600 people in the United States. VERY SATURATED… Of course our population will grow, but not by any significant amount to offset this saturation.

My fellow colleagues, I hope you see what our profession is going to face in the next 10 years. This is what happened to lawyers in the early 2000’s and pharmacists in the mid 2010’s. You are lucky to find a job as a lawyer for more than $50,000 a year when you graduate these days. I have pharmacist friends who state that their salaries have DECREASED in the past 10-15 years and that job opportunities are scarce. One pharmacy student I knew had to move across the country for a job. This is happening to multiple professions, and is now happening to ours.

I personally know nurse practitioners whose salaries have DECREASED in the past 5 years. I have experienced this myself when I lived on the East Coast, which is one of the reasons why I left (independent states are so nice…). I know COUNTLESS nurse practitioner graduates who cannot find a job or can make just as much, if not more, working as a registered nurse because “in home Medicare assessments” just doesn’t pay enough.

Pencil pushers see this saturation occurring. They are not blind to it. They are beginning to take full advantage of the situation to line their own pockets with bigger salaries and bonuses which will result in lower salaries and more hours for us. We are controlled by SHARKS… Additionally, new graduate nurse practitioners will take any job they can find which will lower the salaries even more, simply out of desperation. Further down the rabbit hole we go… Supply goes up, demand goes down, and salaries inevitably decrease.

Now the good news is that this is not happening all over the country, but it is occurring in many areas and will continue to spread. I fear it will be widespread in a matter of 5-10 years.

I hear we need to unionize. We need to make admission standards stricter. The curriculum needs to be more rigorous. You should be an RN for at least 3 years before going back to school. Etc etc etc…

THESE THINGS ARE OUT OF YOUR CONTROL. The only way anything will change is if there is a massive revolt of current nurse practitioners and we bind together and demand change.

This is not going to happen… So, what can YOU do about this? Because you are the only one in charge of your own destiny.

You must mitigate this future risk by starting your own business and becoming as financially redundant as you can. You should strive to develop multiple income streams that are outside of the control of an employer. This can be medical practices, rental properties, a franchise, etc… I own 3 medical practices, 2 businesses outside of medicine, a diverse investment portfolio, and let me tell you: it is AWESOME. The entire healthcare system and economy could crash tomorrow and I would be just fine You need this type of redundancy in your life as well. I advocate every nurse practitioner should open their their own practice and develop multiple income streams. The Elite Nurse Practitioner Model advocates this for long term financial and professional security.

You need to have multiple part time side businesses and/or income streams.

You need to live below your means.

If you are in debt, then you need to aggressively pay it off as fast as possible.

You need to consider moving to a rural area or a state with independent practice.

You should be the most skilled and knowledgeable nurse practitioner you can be. This is done through shadowing, taking actionable courses, and venturing out on your own.

There are tough times ahead folks. You might not want to hear it but put on your reality glasses. Don’t stick your head in the sand. Do everything you can NOW to mitigate the FUTURE risk. Our market is saturated, and it will only continue to get worse…

70 Responses

  1. A second job (side gig) or advanced education are very poor comparisons.
    The author is making the assumption that all things will stay as they are and that education “pays off” for all fields.
    Individual interest is what makes doing anything worth while.
    If the author chooses to make choices that interest him should be the only metric he personally needs.
    Don’t be a nay sayer to others choices.

    1. And….at my system our NP salaries and benefits have increased at a nice pace and we have opportunity to do a clinical ladder, new this year that also offers good annual incentives. My inbox is regularly getting lists of openings. The challenge for the upcoming grads in our market will be the experienced Walgreen NPs that are going to hit the market.

      This author should interview administrators and systems advanced practice leaders.

      1. I have called multiple recruiting agencies. They are overwhelmed with applications. 40 applications for 1 position. You must live and work in a great area. It is not that case in many places.

        1. Justin

          It is funny how a circumstance could change everything including your blog and information.
          Covid-19 proves that we all need more NPs , no one saw that there are numbers of Drs and NPs died as a result of COVID and we still dont have enough care provider, to the point that government had to call retired Drs to help them.

          So Trump or upcoming president will change guidelines to let NPs to practice independently,

          This new era , showed everyone not to be sure of your data! One drastic virus or disaster could change everything

          1. Of course, disasters change the course of human history, this is no surprise. But, once things go back to normal, and they will, the saturation will continue and jobs will become scarcer and scarcer. Visit the Facebook group, there are COUNTLESS NPs who have been laid off during this pandemic. Yes, it was bad in SOME parts of the country, but in most, it was nothing other than an economic disaster. There are thousands of NPs out there without work right now. Thank you for your comment.

  2. The Association of American Medical Colleges predicts a shortage of 21,000 to 55,200 primary care physicians by 2032. NPs are going to be used to fill that gap…states will have no other choice to make independent practice a reality for NPs because there will be no one else to take their place.
    Knowing what you don’t know is an important part of being successful. I have physicans come to me for my expertise in ENT. They don’t have the experience or skills to treat some of these patients and they are not afraid to admit it- they collaborate with each other in the best interests of the patient. We need to work alongside of our colleagues in medicine instead of fighting.

    1. Agreed, we need to work with them. But even adding the 55,200 PCP shortage number to the numbers I quoted still puts us at almost a 100,000 job deficit at current rates. Where are these NPs going to work?

      1. Just out of curiosity, do you make money helping NPs open their own business? Are you the owner of Elite NP?

        1. The reason I asked is that I am interested in creating a website/blog to help each other to expand knowledge and exchange expertise, however this can be time consuming. Given you experience is there money (reasonable) in creating such a site/page? I appreciate your thoughts!

          1. You can monetize a blog if you choose to do so. Is there a lot of money in it? Depends on what you sell through the site. Only piece of advice I can give you is to give it a try.

        2. I do own and operate this blog. I love writing and empowering NPs. I don’t make much off this site. I do consultations as you can see in the page menu.

          1. Justin, Thank you for the article. You nailed it! I have been in practice for over 6 years and I believe current NPs, MDs, PAs need to get together and expose this pseudo-NP schools. This is affecting all of the above and also patients that ultimately suffer from inadequate care.

      2. I would like to see a hard number on how many primary care np students there are. For on-line programs with no in-person meetings and they don’t find preceptors, the only thing that could cap their enrollment is faculty. But the number of DNPs is rising exponentially and they are facing a difficult clinical job market – so many seem to be looking for on-line teaching positions to supplement a dwindling pay. It’s almost like the over-production could be feeding itself.

  3. Also would appreciate it if you let us know how to edit a comment on this blog (sometimes type too fast w/o realizing…). Thanks

  4. Trump just signed a bill to not to expand the scope of practice for a NP or PA. So this does not make it any easier for a NP unless he/she moves to a state that has a law/bill to accept independent practice for NPs.

    1. Yep. I feel sorry for NPs in restrictive states… I moved from one to an independent practice state and it is AMAZING.