It’s been a year since we last wrote about physician assistant salary and that of nurse practitioners, and in that time there have been large changes in our profession, in health care, and most importantly in the economy. Not surprisingly, these changes have had a great influence on mid-level provider income, and more interestingly, the market share for PAs compared to NPs.
Physician Assistant Salary Vs Nurse Practitioner Salary
The data we reviewed is from the Advanceweb for NPs and PAs National Salary Report 2011, and it appears to be collected appropriately. Keep in mind as you review it that this is survey data, and not all survey respondents are necessarily accurate or honest about their income when queried.The report collected usable physician assistant salary data and NP salary data by survey from 3,116 NPs and 1,298 PAs July 1 through Oct. 31, 2011. PAs and NPs were again queried about the annual full-time salary, their specialty, work setting, age, number of years in practice, and some new items were included in the report as well: part-time hourly wages, OTC drug recommendations per week, prescriptions written per week, and number of patients seen per week.
Here are some highlights:
From this, it’s easy to see that physician assistant salaries and those of NPs both dropped, which isn’t surprising, given the weak economy. What is surprising is the difference in how much they fell. Physician assistant salaries fell by 2.0%, and nurse practitioner salaries fell by only 0.2%. What’s going on here?
According to career consultant Renee Dahring, MSN, NP, it has mostly to do with drops in specialist salaries, and physician assistants are a bigger part of this type of care (cardiology, surgery, endocrinology, etc.) than nurse practitioners. So on average, when specialist salaries drop, physician assistants feel it more than NPs. It may also reflect that more specialist physicians and practices are hiring nurse practitioners because they make less on average than physician assistants, and are therefore cheaper to employ.
Does this mean you should abandon on the physician assistant field, and become a nurse practitioner?
We don’t think so.
Although there may be a salary equalizing trend between PAs and NPs, PAs are still more likely to be hired in specialty settings because they are trained to work directly with physicians (that is their mandate), and they are educated with the traditional medical model, which is more similar to that of physicians than that of nurse practitioners. This trend may even reverse as the economy improves. It’s not unlike how investors buy stocks in a strong market, and turn to bonds in a weak one; when the economy is strong, PA’s are a “better fit” for specialty care than nurse practitioners, and when the economy is weak, NPs are a better than PA’s. (Please don’t take this to mean that we think NPs are any less valuable – they aren’t!)
Other notable items:
The top three physician assistant salaries: psychiatry, surgery, and ER.
Surprising as it may seem, once again, mean physician assistant salary in psychiatry is higher than in any other other, including surgery. We always find this interesting. As we have written about in past articles, and we believe there are two primary reasons for this: it’s hard to find people to work in psychiatry – possibly to due to stigma about mental illness and/or aberrant behavior, and new “parity” laws havefinally defined mental illness equivalent to other more “physical” illnesses. Look for salaries in psychiatry to continue to rise now that millions of people with mental illness will soon have health insurance due to the new health care reform.
Physician Assistant Salary Data Overview (New)
The following table gives you an idea about the work life of the average PA and the average NP:
Our interpretations of these data:
- PAs tend to start working at an earlier age, whereas NPs are more likely to be older when they begin. This isn’t so surprising, since to become an NP you need to spend time in nursing first, and PAs have no such requirement.
- The “average” PA sees about 30% more patients per week than the “average” NP. This is probably due to the previously mentioned fact that PAs are more prevalent in specialty practices, and in specialty settings, patient appointments tend to be more focused and brief than in primary care settings. Even at 80 patients per week for physician assistants, the work load is manageable, (20 patients per 4-day work week, or 16 per 5-day work week).
- Physician assistants continue to write more prescriptions and recommend more OTC medications per week than NPs. Again, this may have to do with the number of patients seen by each. Some may also argue that the nurse practitioner curriculum relies a little less on prescription medication than that of physician assistants, and they therefore prescribe less, but this seems unlikely to be a large factor.
Physician Assistant Salary Summary
The results of the 2011 PA and NP salary survey say more about the economy than the professions they measure. Physician assistant salaries and NP salaries in general are down. NPs are feeling it less than PAs because they are less expensive to employ. Men still earn more than women, but the difference is disappearing, particularly in the NP profession, where the average difference in salary between men and women fell from $13,085 in 2010 to $7,396 in 2011 (table not shown here).
Clearly, physician assistant salary continues to be a big draw to the field. In an extended economic downturn, where many are feeling lucky to have jobs at all, PAs are still in great demand, and their salary has dropped a reasonable 2%. NPs may have benefited from the economic woes by increasing their presence in specialized practices. As a result, their salaries have dropped by a mere .2%
Specialist physician assistants (and nurse practitioners), as usual, have consistently higher salaries than those in primary care, although there is reason to believe that this difference may gradually shrink as millions of new patients get health care for the first time, and the demand for primary care rises.