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Are any of you guys worried about the projected oversupply of PAs? I know pharmacy has this problem, but I'm curious to see what you guys think of this.
PA/NP Saturation?
- Thread starter pjm9706
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I see something beginning to manifest itself that is concerning.... New grads are having to hustle to get a job when they graduate. It seems to vary by locality and region, but that's a new trend I read about. I'm an NP student studying psyche, and I have yet to hear of any new grad psyche NPs having any problems finding work, and very few problems concerning income. It's unusual to go to a psyche NP forum/group/message board and hear anyone complaining about money or job offers (except maybe asking for guidance on which offer they should choose). But on FNP or PA boards, I see evidence of a tightening job market. On the PA forums it's pretty much mantra to expect to be able to only pick 2 of 3 desires to shoot for as far as desired salary, desired specialty, and desired location. In other words, if you want to make plenty of money, you can then usually only get either the location you want to live and practice in, OR you can get to practice in the spevialty you want to be in...but not both. That's a shame if it's true. But I also notice that experienced PAs and NPs seem to be desirable to hire. Where I am at, a new trend is to have NPs and PAs be the first provider anyone sees when they first arrive to a practice. It can take a while to book a doctor to see you, and by the time tet do, the NP has already packaged everything up like a present to the physician. But I live west of the Mississippi, and it's growing a lot here, and NPs have a tremendous amount of independence.
I think it's not as bad as pharmacy yet. I've heard firsthand from pharmacy students that things have really gotten wierd in terms of the job market.
Another thing is networking. Most of the NP students I know are connected to the community and working as nurses through school. I already have job offers for when I'm done, and two of them are firm... Like "hey, we will pay you this much as soon as you graduate" firm. I also have people that are ready to precept me, and even providers that are willing to precept and find me other preceptors. Since I am able to stay where I live and didn't have to relocate to go to school. I have that advantage, and I will have work waiting for me if my preceptors end up with a good impression of me. My other NP student friends have had similar arrangements built up. My buddy just got hired by the places he wanted to work for from the beginning, making the money he wants to make, working the specialty he wants... And that is in a location that would be hard for anyone new to break into if they were just applying right out of school with no work history or connections. I'd even say that no new grad NP or PA would have even been considered for those jobs he landed, because the market here is one of the tighter ones around. So a new PA applying from out of state, or coming back to this city after being away wrapped up in PA school would be at a disadvantage. So would a brand new NP who didn't think to do any networking beforehand. I read a lot on NP forums about New NPs who are perplexed that they can't find a job or an NP student who can't find preceptors. In most cases it's because they didn't put in the work to make it happen. My NP friends get trained by some of the best physicians and practices out there in their clinicals, and as a result they get job offers from them more often than not.
So is the job market tightening where I am? For some folks it is. For folks I personally know, the market is booming... But that's not something any of us have left to chance. I've heard of PAs and NPs that weren't similarly prepared as us that are taking jobs starting at $85k. I know an ER PA that is doing well as a new grad (and is off to an awesome start being as they are starting in such an awesome job), but that person told me that they know of other PAs that are settling for less than what I make as an RN with <5 years experience working just a little overtime (and having better benefits and schedule).
But I wouldn't fret if you wan to be a PA or an RN. I'm of the opinion that cream rises to the top. Winners win. Knowing what you are worth is important. So is networking and confidence. As an RN and having moved around to different jobs, I know how negotiations go, and since most RNs with any game are also making decent money, we don't get excited about a job offer of $85k per year from a wealthy medical group that plans to work us 55 hours a week. Someone like me working that much as an RN would make over $120k per year doing that without breaking a sweat or working times we don't want to, or taking call...and I'm not even in a high cost of living locale like California or a coast. I have 4 days off per week, and I decide my schedule (ahead of time) the most part. When I need time off, I take it by either calling in sick (if I'm sick of course), or I have one of my friends switch me or pick up my shift. So me and my friends aren't going to get rolled when we look for jobs. The new grad PA or direct entry NP with large student debt and lack of healthcare experience will most likely be drawn into a bad deal out of a feeling of intimidation or despair, and jump at $85k with a promise from a boss that they will have a lot of orientation.
New grads flooding the market are concerning to some folks too, and there is plenty of that. However, practices are aware by this time that you get what you pay for, and if you pay an experienced PA or NP better, you can expect more out of them usually, and it's almost worth the cost difference to just pay extra for someone that can take in revenue and require less resources. I know this is the case for some of the wealthiest practices because I haven't seen hardly any of their PAs and NPs leave over the years, and they keep driving up to work in sweet cars. When one of them does leave, it's for an offer they can't refuse from another provider that's been hounding them for a long time.
But a new grad putting feelers out through a recruiter or applying remotely from another state without anyone having seen you personally... Be ready to settle.
All I said isn't just bravado... Anyone can obtain it, but it takes work and effort. Opportunity isn't going to come to you. And some folks can fake it, but that almost takes more energy, and is harder to keep up. Make yourself into a hard worker, and be aggressive about networking, and you'll be the good candidate that you portray yourself to be. When I see an RN that is just scraping by and always struggling with whatever job they are in, then it's no surprise when they are complaining on Facebook about how the job market sucks. Then I compare them to mentors of mine that have managers and other hospitals trying to poach them all the time, and the only difference between the two kinds of people is hustle. Not luck, or how poor they grew up, or where they went to school. If I decided on Monday if I needed a new job, I could be working by Thursday. Same for my wife. Someone tried to poach her today right in front of me while we were out and about and ran into an old coworker of hers who is now a boss. So is the job market tight? Not for us. Will it be for me as an NP? Maybe... Because I'm partial to having 4 days off per week and want to make $180k per year after a couple years as an NP. I've been told by other psyche NPs in my area that if I want that arrangement, I may have to settle for $145k per year to work 35 hours a week on a day shift here with no call. Fine. First world dilemma for sure.
Specifically addressing a potential glut of PAs, due to the fact that they are opening up new PA schools all the time because they are cash cows (NP schools are doing this too, albeit far cheaper and less threatening in my opinion)... Yeah, it has potential to flood the market with desperate New PAs with over a hundred thousand dollars of debt. To me, the threat isn't from them being churned out en masse, it's the fact that they are so desperately in debt that they will take anything they can get. NPs can at least get through NP school for as low as $25k and still work. But if a New PA isn't working, they usually have nothing else to tide them over because none of them have decent healthcare backgrounds like nursing that pay well, except maybe folks that were RTs, Rad techs, or Medical technologists in a former life. I know of surgeons that stated openly that in 10 years, PAs will be folks that are considered and paid like allied professions like RTs and Radiology techs. So I think that all these new PA programs popping up, especially the freestanding ones, and the new Yale online PA program (and any other online programs in the mix) will change the landscape as time marches on. Online education is the future though, and I personally love it, but I see potential for it to change the whole landscape if schools are intent on churning out hundreds of PAs and making $100,000 per student to train them to be PAs. Watch how Yale fares with their online program, because that will be the one that every cash hungry university points to when they want to open their own PA program and have each graduating class consist of 200 students. $20 million dollars per year to show recycled lectures and churn out recycled powerpoints with minimal adjunct faculty would tempt anyone. My goal is to make myself valuable enough that by the time that hits. I'm an easy sell vs the new grads.
I think it's not as bad as pharmacy yet. I've heard firsthand from pharmacy students that things have really gotten wierd in terms of the job market.
Another thing is networking. Most of the NP students I know are connected to the community and working as nurses through school. I already have job offers for when I'm done, and two of them are firm... Like "hey, we will pay you this much as soon as you graduate" firm. I also have people that are ready to precept me, and even providers that are willing to precept and find me other preceptors. Since I am able to stay where I live and didn't have to relocate to go to school. I have that advantage, and I will have work waiting for me if my preceptors end up with a good impression of me. My other NP student friends have had similar arrangements built up. My buddy just got hired by the places he wanted to work for from the beginning, making the money he wants to make, working the specialty he wants... And that is in a location that would be hard for anyone new to break into if they were just applying right out of school with no work history or connections. I'd even say that no new grad NP or PA would have even been considered for those jobs he landed, because the market here is one of the tighter ones around. So a new PA applying from out of state, or coming back to this city after being away wrapped up in PA school would be at a disadvantage. So would a brand new NP who didn't think to do any networking beforehand. I read a lot on NP forums about New NPs who are perplexed that they can't find a job or an NP student who can't find preceptors. In most cases it's because they didn't put in the work to make it happen. My NP friends get trained by some of the best physicians and practices out there in their clinicals, and as a result they get job offers from them more often than not.
So is the job market tightening where I am? For some folks it is. For folks I personally know, the market is booming... But that's not something any of us have left to chance. I've heard of PAs and NPs that weren't similarly prepared as us that are taking jobs starting at $85k. I know an ER PA that is doing well as a new grad (and is off to an awesome start being as they are starting in such an awesome job), but that person told me that they know of other PAs that are settling for less than what I make as an RN with <5 years experience working just a little overtime (and having better benefits and schedule).
But I wouldn't fret if you wan to be a PA or an RN. I'm of the opinion that cream rises to the top. Winners win. Knowing what you are worth is important. So is networking and confidence. As an RN and having moved around to different jobs, I know how negotiations go, and since most RNs with any game are also making decent money, we don't get excited about a job offer of $85k per year from a wealthy medical group that plans to work us 55 hours a week. Someone like me working that much as an RN would make over $120k per year doing that without breaking a sweat or working times we don't want to, or taking call...and I'm not even in a high cost of living locale like California or a coast. I have 4 days off per week, and I decide my schedule (ahead of time) the most part. When I need time off, I take it by either calling in sick (if I'm sick of course), or I have one of my friends switch me or pick up my shift. So me and my friends aren't going to get rolled when we look for jobs. The new grad PA or direct entry NP with large student debt and lack of healthcare experience will most likely be drawn into a bad deal out of a feeling of intimidation or despair, and jump at $85k with a promise from a boss that they will have a lot of orientation.
New grads flooding the market are concerning to some folks too, and there is plenty of that. However, practices are aware by this time that you get what you pay for, and if you pay an experienced PA or NP better, you can expect more out of them usually, and it's almost worth the cost difference to just pay extra for someone that can take in revenue and require less resources. I know this is the case for some of the wealthiest practices because I haven't seen hardly any of their PAs and NPs leave over the years, and they keep driving up to work in sweet cars. When one of them does leave, it's for an offer they can't refuse from another provider that's been hounding them for a long time.
But a new grad putting feelers out through a recruiter or applying remotely from another state without anyone having seen you personally... Be ready to settle.
All I said isn't just bravado... Anyone can obtain it, but it takes work and effort. Opportunity isn't going to come to you. And some folks can fake it, but that almost takes more energy, and is harder to keep up. Make yourself into a hard worker, and be aggressive about networking, and you'll be the good candidate that you portray yourself to be. When I see an RN that is just scraping by and always struggling with whatever job they are in, then it's no surprise when they are complaining on Facebook about how the job market sucks. Then I compare them to mentors of mine that have managers and other hospitals trying to poach them all the time, and the only difference between the two kinds of people is hustle. Not luck, or how poor they grew up, or where they went to school. If I decided on Monday if I needed a new job, I could be working by Thursday. Same for my wife. Someone tried to poach her today right in front of me while we were out and about and ran into an old coworker of hers who is now a boss. So is the job market tight? Not for us. Will it be for me as an NP? Maybe... Because I'm partial to having 4 days off per week and want to make $180k per year after a couple years as an NP. I've been told by other psyche NPs in my area that if I want that arrangement, I may have to settle for $145k per year to work 35 hours a week on a day shift here with no call. Fine. First world dilemma for sure.
Specifically addressing a potential glut of PAs, due to the fact that they are opening up new PA schools all the time because they are cash cows (NP schools are doing this too, albeit far cheaper and less threatening in my opinion)... Yeah, it has potential to flood the market with desperate New PAs with over a hundred thousand dollars of debt. To me, the threat isn't from them being churned out en masse, it's the fact that they are so desperately in debt that they will take anything they can get. NPs can at least get through NP school for as low as $25k and still work. But if a New PA isn't working, they usually have nothing else to tide them over because none of them have decent healthcare backgrounds like nursing that pay well, except maybe folks that were RTs, Rad techs, or Medical technologists in a former life. I know of surgeons that stated openly that in 10 years, PAs will be folks that are considered and paid like allied professions like RTs and Radiology techs. So I think that all these new PA programs popping up, especially the freestanding ones, and the new Yale online PA program (and any other online programs in the mix) will change the landscape as time marches on. Online education is the future though, and I personally love it, but I see potential for it to change the whole landscape if schools are intent on churning out hundreds of PAs and making $100,000 per student to train them to be PAs. Watch how Yale fares with their online program, because that will be the one that every cash hungry university points to when they want to open their own PA program and have each graduating class consist of 200 students. $20 million dollars per year to show recycled lectures and churn out recycled powerpoints with minimal adjunct faculty would tempt anyone. My goal is to make myself valuable enough that by the time that hits. I'm an easy sell vs the new grads.
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I can understand why I should be worried, but I am not. When I applied to PA school there was like 130 programs. Now, there are 225 accredited programs. Nearly 100 more programs popped up in the past decade. There has been a big influx of applicants into PA programs. I'm glad I'm not trying to get into PA school now, because I probably wouldn't be able to haha.
I am concerned about the possibility of new grads driving down salaries. As this already happens in areas of heavy PA populations. Although, now that I have a decade of experience, I will certainly stand out to position that don't want new grads. I hope are education remains with high standards and doesn't go in any direction of NP education (with wide variation in programs).
For right now, so long as you are going to a highly preferred city, there are plenty of jobs available.
I am concerned about the possibility of new grads driving down salaries. As this already happens in areas of heavy PA populations. Although, now that I have a decade of experience, I will certainly stand out to position that don't want new grads. I hope are education remains with high standards and doesn't go in any direction of NP education (with wide variation in programs).
For right now, so long as you are going to a highly preferred city, there are plenty of jobs available.
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What's BFE? Base Flood Elevation? Boundary Free Enterprise? Booze Food and Entertainment?
Nevermind...google is your/my friend.
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I'm sorry but PAs would never flood the market if it wasn't for NPs. Yes, there are a lot of PA programs but their average class size is 40 students. Yale is opening an online program, but it is Yale and not some University of Phoenix NP program, which, yes, have been around for a long time now. Now, for NPs: there are over 22,000 NP graduates every year, compare that to 7,000 PAs. In fact, there are more NPs graduating school every year than there are US MD students.
Also, PAs don't have to network for clerkships because no PA program is allowed to make students find their own clinical rotations. So, yea NPs will saturate the market for both professions. However, this would never be an issue if there were only PA programs and if NP programs had 3 times less graduates to match PAs.
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The context was: "flooding the market....with desperate new PAs with over $100,000 debt. To me, the threat isn't in them being churned out en masse, it is the fact that they are so desperately in debt that they will take anything they can get."
The debt drives the desperation. I'm an RN, and when I finish my NP, I have the luxury of being picky with the job I'll take because I make almost as much as a new PA or NP as an RN. PAs are in a tough spot by comparison. And yeah, PA saturation is happening in plenty of markets. Most states will have a glut of both NPs and PAs by 2025, and lack primary care physicians in just about every state. PA and NP fields started at the same time, so I don't think PAs can complain that NPs ran faster than them. NPs aren't going to cut back, and I wouldn't expect PA programs to stop expanding either. So it not about how it should be, it's about how it is.
Online delivery will expand beyond Yale. I'm not against an online format at all. The technology is there, we should be using it more, but it starts at a place like Yale as a test bed, and rolls out from there once they prove it. I could see it producing 20,000 PAs easily within less than a decade. My main problem is all the debt that the students will accrue along the way. Again, glut is going to happen no matter what. The question is how to position to avoid having it affect you.
The debt drives the desperation. I'm an RN, and when I finish my NP, I have the luxury of being picky with the job I'll take because I make almost as much as a new PA or NP as an RN. PAs are in a tough spot by comparison. And yeah, PA saturation is happening in plenty of markets. Most states will have a glut of both NPs and PAs by 2025, and lack primary care physicians in just about every state. PA and NP fields started at the same time, so I don't think PAs can complain that NPs ran faster than them. NPs aren't going to cut back, and I wouldn't expect PA programs to stop expanding either. So it not about how it should be, it's about how it is.
Online delivery will expand beyond Yale. I'm not against an online format at all. The technology is there, we should be using it more, but it starts at a place like Yale as a test bed, and rolls out from there once they prove it. I could see it producing 20,000 PAs easily within less than a decade. My main problem is all the debt that the students will accrue along the way. Again, glut is going to happen no matter what. The question is how to position to avoid having it affect you.
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I agree with you, theres too many green horn RNs graduating from accelerated BSN programs and without even landing a medical surgical position , let alone an ICU position in a heavy trauma hospital, they're already enlisting to go to graduate school to get the DNP ! To be a great practitioner, at least have , in my opinion, 2-3 years of bedside nursing experience in the MedSurg/ ER/ ICU. That is the thesis of the NP paradigm in that we bring to the medical practice the thorough and rigorous experience as a clinical nurse.
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In all honesty, the central argument is -- what created this need for NPs in the first place? The etiology is the critical needs for physicians, PERIOD.
