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%, and the average PA salary grew by more than 12% over 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 $110,590. The report also revealed that PAs working in Alaska, California, and Nevada have the highest median salaries at $125,000.

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 have seen the greatest increase in PAs in recent years were Rhode Island at 13.7%, Arkansas at 11.4%, Nevada at 11.3%, and Indiana at 10.4%.

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

Nurse Practitioner Growth

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

Most of this growth is in primary care due to the shortage of physicians in this specialty and outpatient settings. In addition, many NPs choose to practice in rural areas because these communities are the most in need of access to medical care. The Southeast, including Alabama, Kentucky, Mississippi, and Tennessee, saw the most significant increases in the NP population.

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

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

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

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 to pursue advanced practice education and training in recent years. 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 battling an RN shortage. By 2022, the US Bureau of Labor Statistics predicts there will be 1.2 million RN vacancies, mainly 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.

There are several factors to consider if you’re considering additional education. First, the journey to an MSN or a DNP can be relatively quick for those who've already earned a BSN. 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.