Most important takeaways…
- 42% of Virginia practices lost a physician or APP in 2022.
- Patient satisfaction hit 75.1% for NPs versus 67.9% for physicians.
- Nurse practitioners nationwide earn a median $132,300; top quartile exceeds $156,700.
Forty-two percent of Virginia primary care practices lost a physician or APP in a single year, according to a statewide survey published September 3, 2026 in Frontiers in Medicine. That churn rate reframes burnout as a capacity problem: when a nurse practitioner leaves, the remaining clinicians absorb that panel, and the NP-led primary care team's ability to see patients drops sharply.
Burnout data often reads like an individual wellness metric, but the Virginia findings place it squarely inside team staffing and workflow design. For FNPs in primary care, where FNP scope of practice shapes the daily work, the pressure is not abstract; it appears in unfilled schedules, longer panels, and the administrative load that follows attrition. Workforce instability, not personal resilience, is the variable that most needs attention.
What the New Frontiers in Medicine Study Found
Published September 3, 2026 in Frontiers in Medicine (DOI: 10.3389/fmed.2026.1885926), the study "The role of Advanced Practice Providers in improving primary care capacity: practice perspectives on challenges and opportunities" pairs a statewide survey with qualitative interviews to explain why primary care teams struggle to retain providers. In a 2022 survey of Virginia primary care practices, 42% of practices reported losing at least one physician or advanced practice provider (APP) within the past year, quantifying an NP primary care shortage. That single figure turns a familiar workforce shortage into a measurable turnover problem.
How the Researchers Built the Evidence
The authors paired the survey with semi-structured interviews with fourteen primary care physicians, as described in the article. The interviews captured practice-level views on integrating primary care nurse practitioners and physician assistants into daily care, including both well-understood APP roles and unclear workflow or supervision expectations.
Where the Study Fits
The research comes from a team affiliated with Virginia Commonwealth University's Department of Family Medicine and Population Health and Simmons University School of Nursing. It appears as part of a broader research topic on the health and care workforce from a lifecycle perspective, positioning APP retention and primary care capacity as long-term system challenges rather than temporary hiring gaps. Exact qualitative themes are best reviewed in the full text, but the article's framing centers on challenges and opportunities in APP integration.
How Common Is Burnout Among Primary Care NPs and APPs?
How many nurse practitioners in primary care are actually burned out? The honest answer depends on which survey you read, because researchers define burnout differently and sample different practice settings. Across recent NP and APP studies, prevalence ranges from about 25% in primary care-specific regional data to more than 50% in some national workplace surveys.
The most specific primary care data
A 2021 regional study of 396 primary care NPs in New Jersey and Pennsylvania put burnout at 25.3%. That was slightly higher than the combined primary care NP and PA rate of 22.6% and comparable to primary care physicians in the same study at 25.1%. National primary care physician benchmarks are higher: a separate national analysis placed primary care physician burnout at 57.6% in 2022.
National NP and APRN trends
Broader advanced practice nursing trends show burnout rising from 31.5% in 2018 to 43.1% in 2022, then easing to 39.6% in 2023. In 2024, 40.3% of APRNs reported burnout, and 52% felt emotionally drained. Medscape's 2023 NP report found 38% burned out, with another 27% experiencing both burnout and depression.
Where FNP data falls short
No current national dataset isolates Family Nurse Practitioners in primary care as a subgroup. Most national figures combine hospital, specialty, and primary care NPs. FNP-specific longitudinal tracking remains limited, which is part of why state-level studies like the Virginia survey are needed to understand turnover and burnout in the primary care workforce.
What's Really Driving Burnout in Primary Care Practices
The emotional exhaustion of primary care rarely comes from the patient visit itself; it accumulates in the hours of invisible work around that visit. Sources of strain are unevenly distributed, and for nurse practitioners the friction often shows up differently than it does for physicians.
Panel Size and the Documentation Load
In the 2026 Frontiers in Medicine study, practices identified panel size and workload as the most cited drivers of Nurse Practitioner Burnout. Prior authorizations, inbox management, and after-hours EHR time turn a manageable schedule into a second shift. That administrative layer fuels decision fatigue nurse practitioner and consumes the flexibility NPs often seek when choosing primary care.
Autonomy Limits Create APP-Specific Friction
Burnout among APPs is not simply physician burnout with a different license. In restricted-practice states, NPs may need supervisory agreements for routine decisions, which adds delay and erodes confidence. The study authors described this as friction physicians do not face in the same way; it often surfaces as frustration at being treated as a dependent provider rather than a collaborative clinician.
Onboarding and Mentorship Gaps
New APPs joining primary care teams frequently lack structured onboarding. Without a mentor or a graduated patient ramp-up, early career NPs inherit full panels quickly, which amplifies turnover risk. Practices that invest in onboarding report that new APPs stabilize more rapidly.
Where Practice Authority Changes the Picture
Full practice authority states report different burnout pressure points. When NPs can practice at the top of their license, the stress shifts toward workload and documentation rather than permission-seeking. In restricted-practice states, autonomy barriers add a distinct layer that makes retention harder.
Proven Interventions That Actually Reduce APP Burnout
The table below summarizes interventions with measurable burnout reductions in primary care settings. These include technology, coaching, leadership training, and practice-environment changes. Each row reports data from peer-reviewed or industry studies published between 2020 and 2026.
| Intervention | How It Works | Measured Impact on Burnout |
|---|---|---|
| Ambient AI scribes for ambulatory clinicians including APPs | Clinicians used an ambient AI scribe for 30 days to assist with clinical documentation in ambulatory clinics. | Burnout decreased from 51.9% before to 38.8% after the 30-day intervention. |
| Ambient AI scribes for physicians and APPs | Ambient AI scribe technology was implemented and burnout was measured at baseline and 3 months post-implementation. | Among APPs, 45% reported some level of burnout at baseline compared to 38% at 3 months. |
| Professional coaching for primary care physicians | Participants completed coaching and follow-up assessments in a randomized, waitlisted design. | The primary group had significantly decreased burnout from before coaching to after coaching compared with the waitlisted group. |
| Wellness-centered leadership program for physicians and APPs | A wellness-centered leadership intervention used leadership development plus coaching sessions, with surveys conducted across 2022, 2023, and 2024 to assess burnout and intent to leave. | The intervention was associated with a 16% reduction in burnout and a 16% reduction in intent to leave the organization. |
| Clinician Wellness Council leadership training | A 15-month well-being leadership development training program included monthly large-group education sessions and small-group coaching sessions. | A prior quantitative study reported burnout dropping from 47% to 13% among clinicians who participated. |
| Primary care practice environment improvements for NPs | The study evaluated organizational and practice-environment factors such as professional visibility, NP-physician relations, NP-administration relations, independent practice, and support. | Higher scores on those practice-environment subscales were associated with 51%, 51%, 58%, and 56% lower risk of NP burnout, respectively. |
Related Articles
Nurse Practitioner Salary and Demand in Primary Care
Salary and demand data paint a nuanced picture for nurse practitioners moving into primary care. According to the U.S. Bureau of Labor Statistics, nurse practitioners nationwide earn a median annual wage of $132,300, with the top quartile above $156,700. The most recent HRSA State of the Primary Care Workforce report projects a national surplus of 72,910 primary care NP full-time equivalents by 2038, which suggests that primary care practices will have more capacity to expand NP-led care models rather than facing a national shortage. At the same time, the BLS projects 9% job growth for nurse practitioners from 2024 to 2034, faster than the average for all occupations. These national figures provide a useful benchmark, but actual primary care salaries vary widely by state, experience, and practice setting.
| Occupation | Total employment | Mean annual wage | Median annual wage | 75th percentile |
|---|---|---|---|---|
| Nurse Practitioners | 323,040 | $137,300 | $132,300 | $156,700 |
| Physician Assistants | 162,150 | $141,280 | $135,880 | $163,980 |
| Registered Nurses | 3,379,720 | $101,420 | $97,550 | $112,350 |
Many patients assume they saw a physician, but satisfaction data tells a different story. A review of patient satisfaction studies found that nurse practitioners received a 75.1% satisfaction rate, compared with 67.9% for general practitioners. So the next time someone asks who your primary care provider is, the evidence says the NP in the room can hold their own.
In one year, 42% of Virginia primary care practices lost a physician or APP. That level of turnover is a data-driven wake-up call to expand and support the APP role.
