Inches forward, inches back. That aptly sums up the findings of the 2010 National Salary Survey of Nurse Practitioners and the 2010 National Salary Survey of Physician Assistants. These surveys, conducted by ADVANCE for NPs & PAs, documented small overall salary increases for both professions. But they also recorded a 4.5% drop in hourly pay for NPs who work part time. Given the troubled economy, the findings appear to be encouraging for 2011 and beyond.
Our surveys were conducted using online questionnaires created with Zarca Interactive's survey software. We collected data from Aug. 23 through Nov. 30, 2010. Nearly 3,000 NPs (2,956) participated in the survey designed for nurse practitioners, and nearly 1,300 PAs (1,276) answered the version created for physician assistants. Because 2010 was the first year that ADVANCE surveyed both professions, you'll note some differences in our reporting due to our longer history of gathering data about NP salaries.
National Full-Time Averages
In terms of full-time salaries, PAs make more than NPs. PAs earned an average of $96,876 in 2010 (Table 1), while NPs earned an average of $90,770. The surveys also documented a notable difference in salary improvement between 2009 and 2010: Comparing ADVANCE's 2010 results with 2009 salary data from the American Academy of Physician Assistants, PAs experienced more than twice the salary increase that NPs did. The average PA salary increase was $3,771, while the average NP salary increase was $1,191.
That PAs generally make more money than NPs is not a new observation. This trend appears to be based largely on practice setting. PAs more commonly work in specialties that also generate higher incomes for physicians, such as emergency medicine and surgery (including the really big moneymakers, plastic surgery and aesthetics). Although the PA profession once attracted more men than women, today about 65% of PAs are women, so sex predominance does not explain the salary difference.
In the area of part-time practice, hourly rates had climbed steadily over the years for nurse practitioners (Table 1). But the average hourly rate for an NP dropped from $45.85 in 2009 to $43.77 in 2010, a decrease of 4.5%. PAs earned an average hourly rate of $51.11 in 2010; we are unable to compare that to part-time earnings in 2009 because we did not survey PAs at that time.
Perhaps the most fascinating results are in the category of salary by practice setting (Table 2). Among nurse practitioners, work in an emergency department produced the highest income in 2010 ($104,549), with aesthetics/skin care a close second ($102,547). Mental health was the third highest pay producer for NPs ($100,914), yet it was the No. 1 producer for PAs ($116,758).
Among physician assistants, the second highest paying practice setting was elementary and secondary schools ($115,000). That's in stark contrast to NPs, whose salaries in schools rank 21st among our 22 categories at $77,513. The third highest paying setting for PAs is cardiology ($109,030), and this specialty ranks fourth for salary among NPs ($100,881). Among PAs, the fourth highest paying practice setting is aesthetics and dermatology (No. 2 for NPs). Emergency medicine ranks fifth for PA pay, and oncology ranks No. 5 for NPs.
The Gender Gap Endures
The gender gap long documented in salaries for many professions also is evident among NPs and PAs. As Table 3 shows, men make 12.8% more money than women in the NP profession. In the PA profession, men earn 10.7% more than women. It's interesting that the average salary of male PAs is so close to that of male NPs - a difference of only $398.
So what factors contribute to the salary differences between men and women among PAs and NPs? Practice setting and practice specialty certainly come into play, but further theorizing here might be best left to economists and sociologists. (Do you have an answer to this question? Start a thread on our discussion board under the Community tab at www.advanceweb.com/NPPA.)
What's to Come?
Looking ahead, it appears that NPs and PAs could see their salaries climb at a faster clip but not right away.
Although some states are challenging the mandatory insurance requirement of the Patient Protection and Affordable Care Act, those lawsuits won't solve the critical shortage of primary care providers in the United States. More than half of NPs deliver primary care to some age group, and roughly 40% of PAs do the same. You'll be vital to meeting primary care needs, and because you'll be in demand, salaries are likely to rise in recognition of that.
Michelle Perron Pronsati and Michael Gerchufsky are the editors of ADVANCE for NPs & PAs.