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The VALUE of Subspecialization
The value of subspecialization for nurse practitioners and physician assistants cannot be clearer than it is now. Since the global pandemic, we are seeing providers – including physicians – leave the work force in record numbers. We have also seen changes in patient visit patterns. In fact, emergency department volumes are down almost 30% nationwide at the time of this article. Some of the largest companies who staff hospitals are restructuring or closing their doors. This is leaving thousands of nurse practitioners and physician assistants unemployed. To complicate things, PA and NP schools continue to add new graduates to the job market, and they are finding themselves unemployable.
Benefits of Subspecialization
One of the benefits of being an NP or PA is the ability to change specialty without any extra training. Interestingly, our new job market is making it harder for NPs and PAs to change specialties. Without the prospect of a better position, providers are staying in their positions without other options. This may also contribute to the exodus from healthcare. On the other hand, things have never been better for recruiters. A sea of unemployed NP and PA applicants gives the employer a huge advantage. Getting a foot in the door these days is a real challenge – even if you know what you want to do! Getting a job in a specialty group or practice now takes something special.
Certifying as a sub specialist NP or PA gives providers the best of both worlds. The certification gives them the ability to practice what they like to practice, and also stand out among their peers when they want to find a new job. When faced with the choice between a PA who has been practicing for 2 years, or another PA who has been practicing for 2 years AND has a certificate of added qualification, the choice becomes obvious!
Nurse Practitioners are able to subspecialize in the following areas: acute care, adult gerontology, emergency medicine , family medicine, neonatal medicine, pediatrics, psychiatry, and women’s health.
Physician Assistants can also certify in cardiovascular & thoracic surgery, emergency medicine, hospital medicine, nephrology, orthopedic surgery, pediatrics, and psychiatry.
Subspecialization defines a provider’s skills as standing out above their peers, and also allows them to practice with the added confidence of having certification. Who doesn’t like to show up for work knowing that they are an expert in what they do?
Compensation
Some larger, saturated markets are requiring sub-specialization to get hospital privileges. This effectively makes certification a requirement to practice. Fortunately, this certification also brings the likelihood of higher compensation. Experts get paid more!
According to the AAPA in 2020, the top 5 paying physician assistant specialties were:
According to the AANP 2017 National Compensation Survey, the top 10 nurse practitioner specialities were:
What is the Future of Primary Care?
Growth trends for primary care providers can be expected to follow trends over the next several years:
- The U.S. Bureau of Labor Statistics expected a growth of around 19% in primary care by 2020. Demand for Primary Care will increase even more as patients get older, baby boomer retire, and physicians become outnumbered. As a result, NP expectations and scope of practice will increase, driving more subspecialization.
- Demand for outpatient staff will increase as hospital are under pressure to discharge more patients to the outpatient setting and have management that otherwise would have been performed in the hospital. According to a survey by Clinical Advisor over ¼ of all nurse practitioners currently work in offices.
- Nurses will be sought-after in underserved and rural areas as the physician shortage continues to grow.
- The need for NP Specialization will increase as an aging population brings sicker patients into a system that is being designed to drive them away from hospital admissions. Emergency Medicine will be a focus of this growth.
How to Become Sub-Specialized
Providers can complete certification whether they are seasoned veterans, or new graduates. A small amount of career planning can make specialization an easy reality. Regardless of specialty goals, providers will need designated CME credits for whatever type of additional certification or practice they seek. These are often subject to review by the accrediting body that certifies credits for approval. The NCCPA and the AANP or ANCC have published these for PAs and NPs respectively.
Regardless of current training or area of practice, subspecialization will give all advanced practice providers added security, confidence, income, and stability. It will also allow them to practice what they do best!
Provider Practice Essentials is pleased to announce that we have developed a comprehensive review for emergency medicine certification. The Emergency Medicine Board Review Series includes video review, matched test-style questions, an interactive and adaptive QBank, Visual Flash Cards, Audio Playlists, and a Photo Stimulus review.
