Nurse practitioners (NPs) are happier in their jobs than physicians—in part because their clinical autonomy is expanding as health coverage expands under the Affordable Care Act (ACA), according to a new survey from the American Association of Nurse Practitioners (AANP).

For the survey, private firm Staff Care surveyed 222 NPs attending the 2013 AANP meeting in June and found that 99% said they were optimistic about the future of their profession. The survey also found that:

• 97% would recommend becoming an NP to their own children or other young people;
• 96% would choose to be an NP if they had their careers to do over; and
• 63% said they would continue to be an NP in the next one to three years.

• How do doctors compare? If they could, three in five would quit today

Michelle Hoogerwerf—Staff Care's marketing vice president—says that NPs are happy right now because "all signs are pointing up for them." NPs earn an average of $95,800 a year, their incomes are increasing, and they are getting job offers every day, according to Hoogerwerf.

Doctors, patients become more open to non-physician providers

She added that NPs' clinical autonomy is increasing "as more states allow them to practice a full scope of medicine unsupervised by other disciplines," while physicians have seen their clinical autonomy and reimbursements decline in recent years. "Their importance and prestige is rising as more hospitals, health systems, and accountable care organizations... move to team-based care, in which they play a big part," Hoogerwerf says.

As a result, NPs "are far happier" than physicians, Megan Brooks writes for Medscape Medical News. Many doctors have reported frustration with the direction of their profession—blaming rising regulations, new obligations to use electronic records, and falling reimbursement—although some of their unhappiness may stem from the inherent qualities that make for a successful physician.

NPs may not be ready for the physician shortage

Despite their optimistic outlook, more than 80% of the NPs surveyed said that they do not have any extra time to take on additional responsibilities or patients. That finding suggests that nurses may be unable to ease the projected physician shortage when thousands of newly insured patients seek care after the ACA launches. 

According to the survey:

• 80% of NPs say they are currently overworked or working at full capacity; and
• 75% say that they believe there is an NP shortage.

There are more than 155,000 NPs practicing in the United States, and nearly 90% of those nurses practice in primary care, according to the survey. An estimated 11,000 new NPs complete training each year.

"The hope is that NPs can help address prevailing physician shortages. However, there are already signals that NPs themselves are overextended," says Margaret Crump, COO of the American Nurse Practitioner Foundation (Brooks, Medscape Medical News, 10/11).