Healthy Incomes: Some Nurses Making More than Doctors
By Jennifer Larson, contributor
March 31, 2010 - Though physicians and nurses often work on patients side by side, both sides are aware of the usual disparity in incomes: physicians tend to earn a much higher salary—even when compared to advanced practice nurses who have logged many years of higher education and patient care experience.
But there are some instances when nurses out-earn physicians.
For example, a recent salary survey by physician staffing company Merritt Hawkins found that some advanced practice nurses are making more money than some primary care physicians.
In monitoring physician recruiting trends, the firm reviewed salary data for the primary care physicians (family practitioners, internists and pediatricians) that they recruited and placed in jobs. They found that those salaries increased by double digit percentage points between 2005 and 2009. The firm also found that certified registered nurse anesthetists (CRNAs) that were placed in jobs by the firm in 2009 were offered an average starting salary that was higher than that offered to many primary care doctors. In their sample, a CRNA’s typical starting salary was $189,000, while a pediatrician’s was about $171,000.
Nurse anesthetists are among the highest-paid nurses, earning far above the median annual salary for registered nurses, which was recorded as $62,000 in 2008 by the U.S. Bureau of Labor Statistics.
When comparing physicians’ and nurses’ salaries, however, some point out that it’s not really an accurate comparison to stack up the salary of a CRNA against that of a primary care physician because their jobs are so different.
Christopher Bettin, MA, senior director for communications for the American Association of Nurse Anesthetists, says that it’s like comparing apples to oranges.
“Family practice doctors and what they do…is radically different from what anesthesia providers do, whether they’re CRNAs or anesthesiologists,” he said.
While Bettin acknowledged that nurse anesthetists tend to be well compensated for the work that they do, he noted that a more appropriate comparison might be to compare the salary of a CRNA with that of an anesthesiologist, since both provide anesthesia to patients. “I think that’s a better measurement,” he said.
According to a May 2008 report from the federal Bureau of Labor Statistics, the annual mean salary for an anesthesiologist was $197,570. By comparison, the AANA reports that the annual median salary for CRNAs is $158,000, based on data from about 10,000 CRNAs.
As Bettin alluded, it is also useful compare the salaries of advanced practice nurses who provide primary care services, such as nurse practitioners, to primary care doctors because their work is more comparable.
Mary Jo Goolsby, EdD, MSN, director of research for the American Academy of Nurse Practitioners, noted that the scope of practice for a primary care nurse practitioner (NP) is often the same or very similar to that of a primary care physician. But what about NPs’ annual paychecks? When all specialties and settings were accounted for, nurse practitioner salaries tended to be in the $90,000 range last year, Goolsby reported.
That’s quite a bit less than even the primary care physician salaries that were detailed in the Merritt Hawkins salary survey.
So should nurse practitioners be making more money?
“The salary should be based on the value of care we provide and our role within the practice (or) organization,” according to Goolsby.
It costs substantially less to educate and prepare a nurse practitioner for primary care when compared with the cost to prepare a primary care physician, she added. The AANP analyzed tuition costs for nurse practitioners and compared them with tuition costs for medical school. The resulting report, which was released in January, determined that one year of tuition at a public medical school cost $3,610 more than the entire tuition cost of an MSN program at a public university.
But primary care providers, both nurses and physicians, might be able to look forward to larger paychecks in the future, based on the shortage of primary care providers across large sections of the United States. Merritt Hawkins’s survey showed that salaries and signing bonuses have increased over the last few years as more employers have faced the challenge of finding and employing enough primary care physicians. Salaries for these providers will likely increase as demand outpaces supply, which, in turn, could drive up the salaries of nurse practitioners who may be needed to fill in the gaps.
“NPs have long demonstrated the ability to provide high quality and cost-effective care,” Goolsby said. “Their outcomes are equal to those of physicians, and patients highly value and are satisfied with their care.”
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