50% of job posting exclusively seeking APRNs

[ShakaHoo]

I know this topic has come up several times, but it seems to be getting worse. 
 

With APRNs having the authority to “practice independently” many employers don’t want to be bothered with PAs anymore.

I am concerned that as APRN programs churn out more and more online degrees, it will become very difficult for us to find jobs. 
 

It seems our best hope is the high rate of burnout in our field, and the shortage of healthcare professionals for the aging baby boomer generation…

 

 

Edited June 22, 2023 by ShakaHoo

[sas5814]

It has been discussed ad nauseum. Everyone seems to see this except the people charged with promoting the profession.

Its a long story and explanation regarding why we are disappearing and I have said it so many times I won't repeat it again.

20 years ago I ran for president of our state society on the idea physicians weren't our friends and we needed a unique identity and political agenda that separates us in the minds of regulators, physicians, and the public from NPs. I was shouted down as a mad man with dangerous idea.

3 years ago I said we would be reduced to nothing in 5 to 10 years if we didn't start making ourselves competitive in the marketplace. I was again shouted down as an alarmist...almost exclusively by really old PAs who were already retired or close to it. Now it is happening and they get to shrug and move on unaffected.

AAPA spends way too much time on social issues they really have no effect on so they can virtue signal while the profession crumbles.

I feel sorry for folks who aren't close to retirement.

[Reality Check 2]

The PA profession will die out within 10 yrs and we will be unemployable unless AAPA listens and actually acknowledges the 9000 lb elephant in the room.

AAPA is tone deaf and basically deaf as they refuse to hear anything.

[iconic]

Most PAs I know have an unhealthy obsession with their SP. 
Most physicians want nothing to do with supervision of PAs or NPs/

I do not blame the AAPA, but thousands of apathetic PAs who don't see the bigger picture

Edited June 22, 2023 by iconic

[sas5814]

1 hour ago, iconic said:

I do not blame the AAPA, but thousands of apathetic PAs who don't see the bigger picture

100% a huge part of the problem. Most PAs are unaware of the forces that drive their future. Without awareness of the masses and support for an org that is actually doing things....we are always going to lose ground. It is why the NPs are running laps around us. They have numbers, money, and a political will we don't have.

Edited June 22, 2023 by Hemmingway

[SedRate]

I'll offer another view:

The jobs I've found via job postings haven't been good jobs and/or had red flags in the interview process. The jobs I've found from word of mouth were/are better. 

Perhaps PAs aren't applying for these jobs. Ventana mentioned a while back posting a job and he got zero PA applicants and many underqualified NP applicants.

Perhaps hiring managers get plenty of responses from APRNs who perform a quick Google search and find these often vague job postings. And that, for both the APRN and hiring manager, is good enough. After all, hiring managers are oftentimes so disconnected from the actual job that they don't even know what they're looking for. 

I could see why they'd market to APRNs when they're getting APRN:PA applicants 10:1.

For me, when I'm looking for a position and the post is generic and has copied and pasted every duty a PA can perform including performing an exam and inserting foley catheters yet doesn't even describe the expected schedule/hours, specific duties, etc, I move on. I don't want to work for a place that disconnected. Also, if it says "high volume," "busy," or "must be able to work in a fast paced environment," I liken that to "We're likely understaffed and will overwork you." And if they can't/won't/don't post the expected salary, I don't even waste my time. These standards limit my options significantly.

What's the unemployment rate for PAs and APRNs? Are PA numbers dwindling? What data do we have to support the idea that PAs aren't being hired?

Edited June 22, 2023 by SedRate

[ShakaHoo]

I was simply looking for some "remote" (per-diem) healthcare opportunities to supplement my regular full-time job.  The vast majority of "work from home" positions - exclusively want APRNs (I assume because it is difficult to supervise a PA-C through a computer).  

90% of the Psych positions, Comprehension and Pension Questionnaires for the VA, Telehealth, Etc - all seem to be looking for APRNs.  

 

 

[SedRate]

12 minutes ago, ShakaHoo said:

(I assume).  

Have you tried applying to any of these jobs? Did they ignore or decline your application? Have you followed up asking why you were ignored or declined? 

Edited June 22, 2023 by SedRate

[sas5814]

1 hour ago, SedRate said:

I'll offer another view:

The jobs I've found via job postings haven't been good jobs and/or had red flags in the interview process. The jobs I've found from word of mouth were/are better. 

Perhaps PAs aren't applying for these jobs. Ventana mentioned a while back posting a job and he got zero PA applicants and many underqualified NP applicants.

Perhaps hiring managers get plenty of responses from APRNs who perform a quick Google search and find these often vague job postings. And that, for both the APRN and hiring manager, is good enough. After all, hiring managers are oftentimes so disconnected from the actual job that they don't even know what they're looking for. 

I could see why they'd market to APRNs when they're getting APRN:PA applicants 10:1.

For me, when I'm looking for a position and the post is generic and has copied and pasted every duty a PA can perform including performing an exam and inserting foley catheters yet doesn't even describe the expected schedule/hours, specific duties, etc, I move on. I don't want to work for a place that disconnected. Also, if it says "high volume," "busy," or "must be able to work in a fast paced environment," I liken that to "We're likely understaffed and will overwork you." And if they can't/won't/don't post the expected salary, I don't even waste my time. These standards limit my options significantly.

What's the unemployment rate for PAs and APRNs? Are PA numbers dwindling? What data do we have to support the idea that PAs aren't being hired?

all good thoughts and fair questions. I have had parts of that conversation many times over the last few years. My question is...do we want to wait until there is a lot of data about our demise to react when there is an overwhelming amount of anecdotal evidence that has been getting bigger and bigger by the year? If you hear a tornado and see a tornado do you wait until it hits your house to react?

Put another way if I say we are in trouble and you (metaphorical you..not you specifically) say everything is just fine what is the greater danger? Me being wrong or you being wrong? If we act like we are in a crisis whatever we do can still only benefit the profession. If we sit on our thumbs waiting for undeniable proof, we will be so far behind the curve we cannot recover.

[ShakaHoo]

1 hour ago, SedRate said:

Have you tried applying to any of these jobs? Did they ignore or decline your application? Have you followed up asking why you were ignored or declined? 

I did not apply for jobs specifically seeking a Nurse Practitioner with the listed requirement of having an APRN degree.

 

I suppose I could, and see what happens.

[Hope2PA]

SedRate, yes, PAs have applied!  . It is absolutely true many places, not just crappy jobs, how about surgical that will hire new FNP, no OR experience but will send them for RNFA training because they only hire NP.  How about ENT, FNP, minimal RN experience, not close to ENT, but they want someone they don't have to supervise. Oh, and family med, replace physician and PA with FNP. This happens because of 1-their ability to be independent, and 2-nurse management decides and has the pull to convince admin to only hire NP, no matter the specialty. however sometimes PAs will be considered, and should ALWAYS apply even if advertised for NP. But don't fool yourself, many places will not consider PA, you are ignorant to think otherwise. 

[rev ronin]

7 hours ago, Hemmingway said:

Put another way if I say we are in trouble and you (metaphorical you..not you specifically) say everything is just fine what is the greater danger? Me being wrong or you being wrong? If we act like we are in a crisis whatever we do can still only benefit the profession. If we sit on our thumbs waiting for undeniable proof, we will be so far behind the curve we cannot recover.

Guy I used to work for wrote a book called "Only the Paranoid Survive." Maybe it ought to be gifted to the boards of all four orgs.

[rev ronin]

6 hours ago, ShakaHoo said:

I did not apply for jobs specifically seeking a Nurse Practitioner with the listed requirement of having an APRN degree.

 

I suppose I could, and see what happens.

If they say "But you're not an APRN" you know the comeback, right?

"I'm a PA. We're better trained than APRNs."

[iconic]

31 minutes ago, rev ronin said:

If they say "But you're not an APRN" you know the comeback, right?

"I'm a PA. We're better trained than APRNs."

And the hiring person is a nurse.. lol 

[rev ronin]

8 minutes ago, iconic said:

And the hiring person is a nurse.. lol 

And? If they're too self-interested to acknowledge the truth, do you really want to work there?

[ShakaHoo]

8 hours ago, rev ronin said:

If they say "But you're not an APRN" you know the comeback, right?

"I'm a PA. We're better trained than APRNs."

I am concerned their response would be - you require a supervising physician to work - we do not have a supervising physician, therefore you are not eligible for this position. 

[SedRate]

22 hours ago, Hemmingway said:

all good thoughts and fair questions. I have had parts of that conversation many times over the last few years. My question is...do we want to wait until there is a lot of data about our demise to react when there is an overwhelming amount of anecdotal evidence that has been getting bigger and bigger by the year? If you hear a tornado and see a tornado do you wait until it hits your house to react?

Put another way if I say we are in trouble and you (metaphorical you..not you specifically) say everything is just fine what is the greater danger? Me being wrong or you being wrong? If we act like we are in a crisis whatever we do can still only benefit the profession. If we sit on our thumbs waiting for undeniable proof, we will be so far behind the curve we cannot recover.

Well, no, of course not. I'm trying to understand the root of it. Is it our name? Our state requirements? Nurses in leadership having a bias toward nurses? Non-medical people not understanding who they're hiring? Etc

I've had quite some experience applying for and interviewing with non-medical hiring managers and they overwhelmingly know nothing about PA vs APRN, let alone the actual job. It would seem that we need to focus attention on the people making these hiring decisions. And as you are already well-aware of, that's hard to do when the majority of those folks are nurses who are biased toward hiring other nurses and business people who only see "assistant" and "PAs require supervision."

Edited June 23, 2023 by SedRate

[Cideous]

Better have an exit plan like I did my friends.  Use that degree while it's still possible.  You will take a pay cut, but it's better than not having a job.  If you have student loans, my heart is broken for you.

[SedRate]

21 hours ago, ShakaHoo said:

I did not apply for jobs specifically seeking a Nurse Practitioner with the listed requirement of having an APRN degree.

 

I suppose I could, and see what happens.

I've seen job postings for PA that required an APRN degree. Hell, when I applied for hospital privileges for a large hospital system (one that I had privileges at for another location) they didn't even have PA as an option. I had to tell them to add it. 

I honestly think people are looking for the lowest entry barrier for their candidates so they advertise to APRNs although are likely still open to hiring PAs.

[sas5814]

It is independent vs not mostly. It is a simple financial choice.

Nurses in management

Assistant/name recognition

Nurses marketing themselves aggressively.

NPs outnumber us 2 to 1 or more. They are out graduating us 3 to 1.

NPs are often cheaper to hire and new grads often settle for poor salaries.

NP have stirred hatred among physicians who divide the world into physician/not a physician. Guess which side we are on.

There's probably more. That is just off the top of my head.

[Cideous]

Oh and and we could of been Medical Practitioners, Not Associates...

 

Did you miss me? 

 

 

 

 

[SedRate]

19 hours ago, Hope2PA said:

SedRate, yes, PAs have applied!  . It is absolutely true many places, not just crappy jobs, how about surgical that will hire new FNP, no OR experience but will send them for RNFA training because they only hire NP.  How about ENT, FNP, minimal RN experience, not close to ENT, but they want someone they don't have to supervise. Oh, and family med, replace physician and PA with FNP. This happens because of 1-their ability to be independent, and 2-nurse management decides and has the pull to convince admin to only hire NP, no matter the specialty. however sometimes PAs will be considered, and should ALWAYS apply even if advertised for NP. 

Shakahoo didn't. I gotta think many PAs won't apply for APRN-specific positions for the same reason Shakahoo didn't. I know I wouldn't. But I think you're right: PAs should apply anyway. And at least provide education on the qualifications of a PA where appropriate. 

I actually worked at a surgical place that hired a FNP with no surgical experience. It was a disaster. But that place was also rural and still has that job posting up for over two years now. 

19 hours ago, Hope2PA said:

But don't fool yourself, many places will not consider PA, you are ignorant to think otherwise. 

I don't think otherwise. I actually agree with you. My concern is the preference of hiring less qualified or even highly unqualified candidates because of excuses like admin burden or misconception about ability given "assistant" name or "dependent" status.

I've never had employment problems nor been told I wasn't chosen because they want an independent provider. Then again, all my jobs have had inpatient components which require supervision, even in independent states, so I haven't experienced it myself. I suppose it's much different for outpatient offices and those without enough physicians. 

[SedRate]

17 minutes ago, Hemmingway said:

It is independent vs not mostly. It is a simple financial choice.

Nurses in management

Assistant/name recognition

Nurses marketing themselves aggressively.

NPs outnumber us 2 to 1 or more. They are out graduating us 3 to 1.

NPs are often cheaper to hire and new grads often settle for poor salaries.

NP have stirred hatred among physicians who divide the world into physician/not a physician. Guess which side we are on.

There's probably more. That is just off the top of my head.

After listing all those reasons, realistically, what can PAs do?

Graduate more PAs? No, that would decrease demand.

Take lower salaries? An option but that would bring down pay for everyone 

Get more PAs into admin and management? Definitely would help

Name recognition and aggressive marketing? Definitely

Befriend physicians so we're not lumped in with APRNs? Maybe but would likely require we stay largely dependent otherwise we'll be seen as a threat. 

[sas5814]

6 minutes ago, SedRate said:

After listing all those reasons, realistically, what can PAs do?

Graduate more PAs? No, that would decrease demand.

Take lower salaries? An option but that would bring down pay for everyone 

Get more PAs into admin and management? Definitely would help

Name recognition and aggressive marketing? Definitely

Befriend physicians so we're not lumped in with APRNs? Maybe but would likely require we stay largely dependent otherwise we'll be seen as a threat. 

Independence. The single biggest driving force is economics. Once we are on level economic footing better training and experience, better clinical skills matter. Until the economics balance, nothing else matters.

[SedRate]

2 hours ago, Hemmingway said:

Independence. The single biggest driving force is economics. Once we are on level economic footing better training and experience, better clinical skills matter. Until the economics balance, nothing else matters.

Not to be naive, a Debbie downer, neighsayer, or whatever, but realistically, how would that put us on a level anywhere near APRNs given their clout, sheer numbers, and lobby? Business people have proven they only care about numbers. Independence may put us above on paper, but APRNs riding the coattails of their nursing background (most every layperson I meet thinks nurses can do no wrong, especially nurses who are "doctors") and being churned out will only continue to undermine the PA pool. RNs are trained in and encouraged to get into leadership, management, etc, whereas PAs receive no training or encouragement. There's so much work that needs to be done and given the extreme snail pace of advancement from apathetic views, lack of management presence, lack of awareness, minimal support and lobbying, lack of name recognition (I am still shocked when I have to explain what a PA is to people), etc, I'm afraid at this point we are much too far behind to even hope to catch up. So I'm wondering, and I've said this before, instead of competing with APRNs, is there a niche we can fill and pivot our focus toward? And honestly, I'm now starting to think that doctorate-level training is the only way to expedite this. After all (and this is rhetorical), everyone knows what a "doctor" is and doesn't question that. Right?