Are Nurse Practitioners Leaving Primary Care?

Last Updated/Verified: Jun 28, 2024

Nurse practitioners (NPs) have always been essential in addressing the shortage of primary care physicians, especially in rural and underserved areas. However, despite having several hundred thousand NPs employed across the country, only about 34 percent chose to work in primary care as of 2021, according to a study by the Milbank Memorial Fund. Instead, many are increasingly moving towards specialty care, as outlined in a recent article in the Washington Post. This trend raises concerns about the future availability of primary care providers. Here, we explore the reasons behind this shift and its potential implications for healthcare.

Financial Incentives

One of the primary factors driving NPs from primary care to specialty care is financial incentive. For example, reports that the average national salary for a general nurse practitioner is around $124,000 per year in 2024. For an emergency nurse practitioner, the average salary lands at just over $134,000 annually. While these figures can fluctuate due to location and demand, this disparity remains a significant motivator, particularly as the cost of living rises and student loan debt remains a burden for many healthcare professionals.

Higher compensation in specialty fields naturally attracts NPs, much like it does for physicians, who also often opt for higher-paying specialties over primary care.

Find out more about Nurse Practitioner Salaries.

Professional Development and Flexibility

Another allure of specialty care is the opportunity for professional development. Advanced programs and certificates are available in subspecialties such as cardiology, orthopedics, and more, though enrollment in these programs is often not mandatory for NPs to practice in a specialty. This relative ease of transition, especially compared to other healthcare providers such as physicians, allows NPs to explore and move into specialties with less bureaucratic hassle.

Learn more about Nurse Practitioner Specialties.

Demand for Specialized Care

The demand for specialized care is growing, which further encourages NPs to move into these areas. According to the federal Bureau of Labor Statistics, the nurse practitioner occupation is projected to grow 38 percent by 2032. This growth is partly driven by an aging population with increasing healthcare needs, many of which require specialized knowledge and treatment. This high demand for NPs in specialty roles highlights the expanding opportunities and attractive career prospects outside of primary care.

Impact on Primary Care

The migration of NPs from primary care to specialty care raises significant concerns about the future of primary care availability. Primary care is fundamental to preventive health and the management of chronic conditions, which are critical for improving overall health outcomes and reducing healthcare costs. The reduction in primary care providers could hinder these benefits, placing more strain on the healthcare system and adversely affecting patient care, especially in underserved and rural areas.

What Will Attract NPs Back to Primary Care?

The shift of nurse practitioners from primary care to specialty care is driven by various factors, including financial incentives, opportunities for professional development, and high demand for specialized services. While this trend offers NPs enhanced career prospects and the ability to meet specific patient needs more effectively, it also raises concerns about the future of primary care availability.

Addressing these issues may require policy interventions to make primary care more financially attractive and professionally rewarding for NPs. Ensuring a balanced distribution of healthcare providers is essential for maintaining comprehensive and accessible healthcare for all populations. As the healthcare landscape continues to evolve, understanding and managing the factors influencing NPs’ career choices will be crucial in addressing the broader challenges facing the healthcare system.

Judy Daniels, MSN, RN, AGPCNP-BC