More Newly Licensed Nurse Practitioners Choosing to Work in Primary Care, Federal Study Finds

Jun 10, 2014, 9:00 AM

For more than a decade, the percentage of newly licensed nurse practitioners who chose to work in primary care was on the decline. But that trend is changing, according to a survey released last month by the Health Resources and Services Administration (HRSA).

Fifty-nine percent of nurse practitioners (NPs) who graduated in 1992 or earlier went into primary care, and 42 percent of those who graduated between 2003 and 2007 did so, according to the survey. But 47 percent of the very newest NPs—those graduating between 2008 and 2012—opted to work in primary care, reversing the downward trend.

“We are encouraged by the national growth of primary care nurse practitioners, and HRSA is committed to continuing this trend to ensure an adequate supply and distribution of nurses for years to come,” HRSA Administrator Mary K. Wakefield, PhD, RN, said in a statement.

Susan Schrand, MSN, CRNP, a family nurse practitioner and executive director of the Pennsylvania Coalition for Nurse Practitioners, agreed. “We’re excited,” she said. “It’s good to hear that nurses, and especially new graduates, are staying in primary care.”

New laws that enable NPs and other advanced practice nurse practitioners to practice to the full extent of their training and expertise are drawing more nurses into the primary care workforce, said Schrand, a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow (2013-2016). That will help correct regional imbalances in the nursing workforce that have led to primary care provider shortages in some parts of the country. And that, in turn, will increase access to care, improve wellness, and reduce costs, she said.

“This is an important trend,” agreed Tine Hansen-Turton, MGA, JD, FAAN, chief strategy officer at the Public Health Management Corporation. “Health care reform won’t succeed unless we have enough primary care providers. An uptick in NPs providing primary health care helps the overall system because it creates more access points to care.”

The National Sample Survey of Nurse Practitioners summarizes data collected from nearly 13,000 randomly-selected licensed NPs across the country. It was conducted in 2012 and released last month.

Of the estimated 154,000 licensed NPs working in the United States, 127,000 were providing patient care and about 60,000 worked in primary care, the survey found. About 22,000 licensed NPs were not working in an NP position at the time of the survey and, of these, approximately 11,000 were working as RNs. Three quarters (76 percent) of the NP workforce maintained certification in a primary care specialty, with nearly half having a family NP certification, the survey found.

Other findings, according to HRSA, showed that:

  • The average age within the NP workforce was 48 years.
  • Ninety-six percent of the NP workforce reported being in clinical practice, providing direct patient care. Nearly 3 percent were in faculty positions and approximately 1 percent were in administrative positions.
  • More than half of the NP workforce reported working in ambulatory care settings in their principal NP positions. Nearly one-third of the NP workforce practiced in hospitals.
  • NPs working in primary care settings reported a median salary of $82,000.
  • Overall, NPs in the workforce reported high levels of job satisfaction. NPs were most satisfied with their level of autonomy, time spent on patient care, sense of value for what they do, and respect from physicians and colleagues.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.