How Doctors Really Feel About Managing NPs and PAs

As Advanced Practice Practitioner hiring accelerates across healthcare, results from our first large-scale doctor satisfaction survey reveal the hidden tradeoffs for physicians.

As health systems across the country double down on hiring NPs and PAs (collectively known as APPs/NPPs), physicians are being asked — and often expected — to take on supervisory roles, often without allotted time to supervise. What impact might this have on their actual job satisfaction and compensation?

As part of Offcall’s mission to bring more transparency and autonomy to physicians, we’re collecting data on important career topics such as compensation, job satisfaction, actual hours worked, contract stipulations, burnout, and more. We’ve asked thousands of verified physicians to answer a few simple, optional questions (thank you, users!) and we’re excited to release some of the most interesting findings.

First up, we’re tackling how managing NPs and PAs impacts physician job satisfaction and pay. As Offcall co-founder Graham Walker has written about previously, this topic gets emotional quickly, but what the data actually shows is both fascinating and troubling.

We asked every physician whether they manage APPs or not, along with their total compensation and reported job satisfaction on a scale of 1 to 5. Then we tabulated the data across specialties.

1. Key Finding #1: Emergency Medicine: Lower Satisfaction, Supervision Risk — But Not Higher Pay

Emergency medicine physicians who oversee APPs report notably lower job satisfaction (3.40 vs. 3.72 on a 5-point scale) than those who do not. Meanwhile, those who manage APPs also report a negligible difference in pay – earning just $16 more per hour despite absorbing a much higher level of clinical and legal risk — supervising other clinicians.

“It’s easy to see why health systems are motivated financially to staff emergency medicine teams with more APPs, but this data shows the toll this can take on emergency physicians, who must supervise others without extra compensation or support,” said Graham. “This data is pretty consistent with what I hear from other emergency physicians across the country.”

Below we highlight several other themes, reviewing specialties like Anesthesiology and Neurology, and also make several hypotheses around specialty workload and workflow and how that may impact satisfaction and salary as well.

It’s not nearly as straightforward as the trends we’re seeing in emergency medicine.

2. Key Finding #2: Anesthesiology Tells a Similar Story