Salary Progress Slows for NPs

Salary Progress Slows for NPs Full-time nurse practitioner salaries inched upward in 2010, but part-time wages dropped 4.5%. The findings certainly are not surprising given the economic circumstances of the past few years. This report, which presents only NP salary data, breaks down salary by work setting, gender, geographic location and academic degree. Does an emergency department position pay more than a cardiology position? Read on to find out. photography by JEFFREY LEESER August 2011 Merion Matters Inc.

National Salary Report 2010 Inching Forward With Mixed Results By Michelle Perron Pronsati and Michael Gerchufsky 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. Survey Background 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 Michelle Perron Pronsati and Michael Gerchufsky are the editors of ADVANCE for NPs & PAs. Table 1 NP & PA Salaries, 2001 2010 Nurse Practitioners 2010 2009 2007 2005 2003 2001 Average full-time NP salary $90,770 $89,579 $81,397 $74,812 $69,203 63,172 Average part-time NP hourly rate $43.77 $45.85 $40.32 $36.80 $33.89 $32.53 Sources: National Salary Survey of Nurse Practitioners, conducted in 2001, 2003, 2005, 2007 and 2009 by ADVANCE for Nurse Practitioners. In 2010, conducted by ADVANCE for NPs & PAs. Physician Assistants 2010 2009 2007 2005 2003 2001 Average full-time PA salary $96,876 $93,105* $86,214* $81,129* $76,039* $71,046* Average part-time PA hourly rate $51.11 Sources: National Salary Survey of Physician Assistants, conducted in 2010 by ADVANCE for NPs & PAs; *American Academy of Physician Assistants National Physician Assistant Census Reports for each given year. page 2

Table 2 2010 Salaries by Practice Setting Nurse Practitioners* (in descending order by salary; based on 2,956 responses) Primary Work Setting 2010 Salary 2009 Salary Change in % Emergency department $104,549 $104,369 0.2% increase Aesthetics/skin care $102,547 $105,152 2.5% decrease Mental health $100,914 $100,140 0.8% increase Cardiology clinic $100,881 $90,159 11.9% increase Oncology clinic $98,327 $88,856 10.6% increase Hospital $93,943 $93,694 0.3% increase Neonatal unit $93,925 $95,280 1.4% decrease Geriatric $93,668 $91,863 1.9% increase House calls $93,390 $98,915 5.6% decrease Corrections $91,630 $88,880 3.1% increase Surgery $91,511 $90,959 0.6% increase Retail clinic $90,170 $89,049 1.2% increase HIV clinic $89,857 $88,086 2.0% increase Diabetes/endocrinology $89,710 $85,244 5.2% increase Internal medicine $88,287 $88,903 0.6% decrease Family practice $86,518 $86,520 0.002% decrease Pediatric practice $85,618 $83,926 2.0% increase Women s health $83,687 $83,319 0.4% increase Academia $80,400 $81,552 1.4% decrease College health (12 mos.) $79,139 $81,981 3.4% decrease Elementary or secondary school $77,513 $76,965 0.7% increase College health (9 mos.) $60,829 $63,452 4.1% decrease Physician Assistants (in descending order by salary; based on 1,276 responses) Primary Work Setting 2010 Salary Mental health $116,758 Elementary or secondary school $115,000 Cardiology practice $109,030 Aesthetics/dermatology practice $107,727 Emergency department $103,489 Surgery $102,760 Hospital unit (other than surgery or emergency department) $97,680 Nursing home, assisted living or long-term care facility $96,364 Worksite $95,296 Academia $95,215 House calls $94,383 HIV clinic $91,333 Retail clinic $91,188 Family practice $90,528 Women s health practice $87,974 Pediatric practice $86,894 Oncology practice $85,851 College or university clinic $85,441 Correctional facility $81,404 Diabetes/endocrinology practice $69,000 *Year-to-year comparison available for NPs only. 2010 was the first year ADVANCE collected data on PAs. 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, page 3

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. Part-Time Pay 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. Practice Setting 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. Table 3 Salaries by Gender Nurse Practitioners In the NP profession, women make 12.8% less than men. Gender 2010 salary Women (80% of NP respondents) $89,186 Men (20% of NP respondents) $102,271 Physician Assistants In the PA profession, women make 10.7% less than men. Gender 2010 salary Women (54.62% of PA respondents) $91,662 Men (45.38% of PA respondents) $102,669 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. page 4

2010 Nurse Practitioner Salaries by State Detailed State Breakdown in Alphabetical Order (first entry is full-time salary, second entry is part-time hourly rate) STATE TOTAL RESPONSES MEAN MINIMUM MAXIMUM MEDIAN Alabama 34 $85,117 $65,000 $112,000 $83,500 $37.97 $28.00 $45.00 $40.41 Alaska 12 $105,883 $85,000 $132,000 $107,217 $52.50 $45.00 $60.00 $52.50 Arizona 100 $95,461 $35,000 $200,000 $93,000 $56.74 $37.00 $100.00 $54.00 Arkansas 104 $80,317 $83,000 $125,000 $80,000 $47.38 $33.00 $80.00 $46.00 California 137 $109,886 $60,000 $175,000 $107,000 $52.19 $36.00 $112.00 $46.75 Colorado 52 $92,641 $58,000 $200,000 $90,000 $45.72 $35.00 $53.00 $47.00 Connecticut 50 $100,092 $73,000 $220,000 $92,800 $50.70 $34.00 $75.00 $47.32 Delaware 14 $91,187 $65,000 $130,000 $86,000 $45.93 $32.00 $55.00 $49.30 District of $99,793 $69,000 $140,000 $94,800 Columbia 18 $38.48 $28.00 $44.45 $43.00 Florida 186 $93,529 $85,000 $145,000 $87,750 $43.67 $25.00 $65.00 $45.00 Georgia 91 $83,183 $66,000 $130,000 $85,000 $45.25 $33.75 $70.00 $45.00 Hawaii 12 $100,781 $80,000 $140,000 $94,000 $45.00 $45.00 $45.00 $45.00 Idaho 19 $92,274 $59,000 $165,000 $90,000 $41.75 $40.00 $45.00 $41.00 Illinois 95 $87,225 $70,000 $120,000 $86,000 $41.01 $30.00 $52.00 $42.00 Indiana 84 $82,849 $50,089 $114,400 $84,000 $41.55 $30.00 $50.00 $42.00 Iowa 52 $87,043 $85,000 $160,000 $84,765 $41.93 $36.73 $49.00 $41.00 Kansas 53 $89,568 $55,000 $150,000 $85,750 $41.05 $32.75 $48.53 $41.50 Kentucky 44 $84,568 $49,000 $160,000 $78,500 $50.75 $32.00 $75.00 $43.00 Louisiana 45 $92,395 $50,000 $200,000 $90,000 $40.81 $38.07 $45.00 $40.00 Maine 15 $85,846 $71,000 $113,000 $84,000 $40.00 $38.00 $42.00 $40.00 Maryland 65 $90,243 $80,600 $123,630 $106,936 $46.28 $35.00 $57.75 $47.00 Massachusetts 72 $63,500 $98,361 $141,000 $94,000 0 (this respondent $43.65 $79.00 $41.50 is unemployed) Michigan 83 $90,406 $124,800 $350,000 $86,000 $50.20 $33.75 $80.00 $44.00 Minnesota 51 $96,072 $45,000 $235,000 $93,400 Mississippi 59 page 5 $43.01 $88,552 $40.17 $36.00 $60,000 $37.50 $50.00 $160,000 $35.00 $43.66 $87,000 $48.00 STATE TOTAL RESPONSES MEAN MINIMUM MAXIMUM MEDIAN Missouri 84 $83,609 $70,000 $127,000 $85,000 $46.35 $34.35 $50.00 $42.17 Montana 7 $76,183 $63,000 $132,000 $110,000 $39.00 $39.00 $39.00 $39.00 Nebraska 9 $79,551 $50,000 $100,500 $78,750 $43.82 $30.00 $67.50 $48.75 Nevada 10 $92,700 $75,500 $101,000 $92,000 $51.80 $44.00 $65.00 $45.00 New Hampshire 23 $89,800 $65,000 $115,000 $88,500 $47.67 $41.00 $54.00 $48.00 New Jersey 61 $96,642 $69,000 $140,000 $92,155 $51.67 $41.50 $65.00 $50.00 New Mexico 27 $103,763 $80,000 $200,000 $98,000 $49.00 $47.00 $51.00 $49.00 New York 141 $91,127 $70,000 $180,000 $90,000 $47.40 $28.75 $78.00 $53.37 North Carolina 129 $87,404 $54,000 $150,000 $86,000 $46.09 $22.00 $100.00 $42.00 North Dakota 16 $75,460 $75,000 $106,080 $77,997 $35.86 $27.00 $45.00 $35.73 Ohio 125 $85,570 $32,000 $275,000 $83,704 $42.75 $42.00 $32.00 $55.00 Oklahoma 28 $90,480 $50,000 $135,000 $85,500 $42.00 $42.00 $42.00 $42.00 Oregon 26 $104,111 $43,000 $250,000 $90,000 $45.22 $40.00 $53.00 $45.50 Pennsylvania 137 $83,533 $79,000 $160,000 $84,000 $43.78 $25.00 $68.00 $44.00 Rhode Island 7 $97,500 $90,000 $110,000 $95,000 $46.91 $45.00 $50.00 $45.73 South Carolina 29 $83,397 $74,000 $160,000 $85,300 $41.50 $29.00 $50.00 $43.50 South Dakota 10 $85,285 $72,000 $114,400 $79,000 $34.60 $30.80 $41.00 $32.00 Tennessee 115 $83,490 $60,000 $200,000 $80,000 $44.17 $25.00 $60.00 $45.00 Texas 144 $103,924 $70,000 $150,000 $110,000 $46.88 $32.25 $70.00 $45.00 Utah 31 $91,541 $85,000 $130,000 $94,000 $43.65 $38.50 $53.00 $40.50 Vermont 7 $68,625 $55,000 $85,000 $70,000 $42.67 $30.00 $53.00 $45.00 Virginia 77 $82,674 $50,000 $168,000 $81,000 $42.16 $28.00 $56.00 $42.75 Washington 48 $98,255 $30,000 $150,000 $97,000 $44.14 $37.50 $55.00 $43.00 West Virginia 10* $80,400 $70,000 $100,000 $79,250 Wisconsin 78 $87,373 $62,000 $200,000 $86,000 $42.80 $36.00 $50.00 $42.00 Wyoming 5 *No respondents reported part-time wages $80,000 $75,000 $85,000 $80,000 $45.00 $40.00 $50.00 $45.00

2010 NP Salaries by Select Cities Alabama Birmingham $76,250 Mobile $90,666 Montgomery $100,000 Alaska Anchorage $108,250 Fairbanks Juneau Arizona Phoenix $99,370 Tucson $86,591 Mesa $81,902 Arkansas Little Rock $81,529 Fayetteville $85,260 California Los Angeles $107,774 Oakland $104,446 San Diego $105,647 San Francisco $117,071 San Jose $89,684 Colorado Boulder $88,600 Colorado Springs $117,900 Denver $77,158 Connecticut Bridgeport $92,035 Hartford $93,656 New Haven $102,454 Stamford Delaware Wilmington $87,000 Florida Jacksonville $87,280 Miami $96,769 Orlando $89,025 Tallahassee $75,400 Tampa $94,976 Georgia Athens $75,500 Atlanta $84,764 Augusta $75,200 Columbus $83,000 Savannah $89,514 Hawaii Ewa $90,000 Honolulu $97,666 Idaho Boise $96,015 Illinois Chicago $88,706 Peoria $89,040 Rockford $89,000 Springfield $83,680 Indiana Evansville $85,000 Fort Wayne $67,462 Gary $86,700 Indianapolis $82,115 Iowa Cedar Rapids $78,833 Des Moines $92,656 Kansas Kansas City $86,437 Topeka $86,625 Wichita $96,208 Kentucky Lexington $94,450 Louisville $82,337 Louisiana Baton Rouge $88,125 Lafayette $104,333 New Orleans $88,262 Shreveport $94,407 Oregon Portland $87,333 Maryland Annapolis Baltimore $89,571 Bethesda $107,740 Columbia Silver Spring $103,496 Massachusetts Boston $97,100 Lowell $89,600 Springfield $108,000 Worcester $101,812 Michigan Ann Arbor $86,480 Detroit $90,130 Flint $52,374 Grand Rapids $82,615 Lansing $97,833 Minnesota Duluth $93,400 Minneapolis and St. Paul $93,988 Rochester $91,600 Mississippi Biloxi $108,800 Jackson $90,303 Oxford $94,000 Missouri Kansas City $86,423 Springfield $77,610 St. Louis $75,948 Montana Billings Great Falls Missoula $84,000 Nebraska Lincoln $74,613 Omaha $82,821 Nevada Las Vegas $103,000 Reno $83,750 NP Select Cities continued page 6

2010 NP Salaries by Select Cities New Hampshire Manchester $98,333 Nashua $80,000 New Jersey Camden $96,250 Newark $91,444 Trenton $102,600 New Mexico Albuquerque $81,666 Las Cruces $135,666 Santa Fe $127,000 New York Buffalo $92,308 New York City $100,141 Rochester $78,500 Syracuse $87,800 New York City Boroughs Brooklyn $103,300 Bronx $105,000 Manhattan $103,081 Queens $96,500 Staten Island North Carolina Charlotte $92,981 Greensboro $82,250 Raleigh-Durham $82,106 Winston-Salem $85,083 North Dakota Bismarck $71,471 Fargo $81,000 Ohio Akron $81,469 Cincinnati $92,185 Cleveland $86,723 Columbus $87,107 Toledo $80,400 Oklahoma Oklahoma City $97,833 Tulsa $83,400 Norman Oregon Eugene Portland $82,825 Salem $109,000 Pennsylvania Allentown $77,999 Erie $73,357 Philadelphia $94,349 Pittsburgh $77,921 Rhode Island Providence $100,000 South Carolina Charleston $85,875 Columbia $100,575 Greenville $92,428 South Dakota Rapid City $75,000 Sioux Falls $78,000 Tennessee Knoxville $79,188 Memphis $85,256 Nashville $81,028 Texas Austin $100,500 Dallas-Ft. Worth $96,244 El Paso $104,000 Houston $98,989 San Antonio $95,165 Utah Provo Salt Lake City $94,343 Vermont Burlington $72,500 Virginia Norfolk Richmond Virginia Beach Northern Va.-D.C. Washington Seattle $99,333 Spokane $94,500 Tacoma $107,714 Vancouver $79,075 West Virginia Charleston $88,000 Huntington Wisconsin Green Bay $119,081 Madison $91,200 Milwaukee $84,526 Wyoming Cheyenne $82,500 page 7

2010 NP Average Salaries According to Academic Degree 2010 Doctoral Degree Salary Breakdown Associate degree (1.62%) $84,226 Bachelor s degree (3.21%) $87,237 Type of Doctoral Degree DNP (2.67%) $97,572 PhD (1.73%) $89,242 Doctoral degree (4.84%) $95,089 Master s degree (90.32%) $90,048 DNSc (0.10%) $78,500 EdD (0.27%) $102,885 Other nursing doctorate (0.07%) $112,000 page 8

2010 National Nurse Practitioner Salary Survey Questionnaire Questionnaire Breakdown With Results (Total respondents = 2,956) Editor s note: This breakdown does not include the questions about city and state of residence. For data reflecting salary averages in states and select cities, see those individual breakout reports. What type of nurse practitioner certification do you hold? None: 1.11% Acute Care: 5.60% Adult: 15.89% Adult Psychiatric Mental Health: 2.67% Dermatology: 0.17% Family: 54.99% Family Psychiatric Mental Health: 1.21% Gerontologic: 2.33% Neonatal: 0.88% Oncology: 0.61% Pediatric: 6.71% Pediatric Acute Care: 0.61% Women s Health: 7.22% Do you hold an additional NP certification? No: 85.76% Yes: 14.24% What is the highest degree you have obtained? Associate: 1.62% Bachelor s: 3.21% Master s: 90.35% Doctorate: 4.82% What is your current nurse practitioner position? Not working as an NP: 1.38% Academician: 1.29% Acute Care NP: 9.51% Adult NP: 19.45% Adult Psychiatric Mental Health NP: 3.28% Aesthetics/Dermatology NP: 0.81% Family NP: 34.40% Family Psychiatric Mental Health NP: 1.52% Gerontologic NP: 3.21% Neonatal NP: 0.74% Oncology NP: 3.61% Women s Health NP: 9.10% Pediatric NP: 7.24% Pediatric Acute Care NP: 1.32% Retail Health NP: 1.89% School NP: 1.18% What is your primary employment setting? Academia: 2.87% Aesthetics/Skin Care Practice: 1.01% Cardiology Clinic: 2.56% College Health (9 months): 0.81% College Health (12 months): 1.15% Corrections: 1.01% Diabetes/Endocrinology Clinic: 1.28% Elementary or Secondary School: 0.81% Emergency Department: 4.01% Family Practice: 23.28% Geriatric Setting: 3.61% HIV Clinic: 0.74% Hospital (not a private practice in a hospital): 16.84% House Calls: 1.05% Internal Medicine: 10.29% Mental Health Setting: 3.95% Neonatal Unit: 0.64% Oncology Clinic: 3.91% Pediatric Clinic: 5.70% Retail Clinic: 2.97% Surgery Setting: 2.56% Women s Health Setting: 8.94% Do you work in a subspecialty? No: 54.08% Yes: 45.92% Do you own your own practice? No: 97.27% Yes: 2.73% How many hours a week do you work in your primary employment setting? Full Time (35 hours or more): 83.10% Part Time (less than 35 hours): 16.90% What is your current full-time annual salary? $90,770 What is the hourly rate of your primary part-time position? $43.77 Questionnaire continued page 9

2010 National Nurse Practitioner Salary Survey Questionnaire Questionnaire Breakdown With Results (Total respondents = 2,956) Editor s note: This breakdown does not include the questions about city and state of residence. For data reflecting salary averages in states and select cities, see those individual breakout reports. How many years have you practiced as a nurse practitioner? 9.29 years Does your job include call duty? No: 76.38% Yes: 23.62% Do you get paid for being on call? No: 69.33% Yes: 30.53% How is your on-call pay calculated? Specific Amount for Unlimited Hours or Calls: 30.70% Base Amount Plus Extra for Calls: 17.21% Hourly Rate: 24.65% Percentage of Salary: 7.91% Other: 19.07% Which of the following benefits does your employer offer, either fully or partially paid? (check all that apply) Health Insurance: 85.56% Paid Continuing Education: 75.74% Professional Association Dues: 42.68% Paid Time Off: 85.12% Profit Sharing: 15.99% Retirement Plan: 75.20% Tuition Reimbursement: 36.34% Malpractice Insurance: 83.13% Other: 12.92% Do you purchase your own malpractice insurance (whether or not your employer offers it)? No: 73.82% Yes: 26.18% On average, about how many patients do you see per week? 64.95 patients On average, how many recommendations for over-the-counter medications do you make per week? 29.57 recommendations On average, how many prescriptions do you write per week? 63.27 prescriptions Do you plan to open your own healthcare-related business in the next 5 years? No: 89.78% Yes: 10.22% Select the most appropriate descriptor for the geography of your work setting. Rural: 24.53% Suburban: 37.65% Urban: 37.82% What is your gender? Female: 91.97% Male: 8.03% What is your age? 47.79 page 10