September 20, 2019 Advisory Board's take: The changing market demand for APPs

Glassdoor this week released its 2019 list of the 25 "Highest Paying Jobs" in the United States, and six are in health care.


For the list, Glassdoor identified the 25 highest paying jobs using a proprietary statistical algorithm that estimates annual median base pay, controlling for factors like location and seniority.

Glassdoor only included jobs that received at least 100 salary reports from U.S.-based employers between July 1, 2018 and June 30, 2019. The report accounts for "job title normalization," whereby similar job titles are grouped together. The report did not include C-suite-level jobs.

The Highest Paying Jobs

Health care professions made up six of the top 25 highest paying jobs and five of the top 10.

Physician was the highest paid job on the list, at a median base salary of $193,415. Along with physician, the other five health care occupations on Glassdoor's list, with their ranking noted, are:

  1. Pharmacy manager ($144,768);
  2. Dentist ($142,478);
  3. Pharmacist ($126,438);
  4. Physician assistant ($113,855); and
  5. Nurse practitioner ($109,481) ("Highest Paying Jobs," Glassdoor, accessed 9/19; Liu, CNBC, 9/18).

Advisory Board's take

The changing market demand for APPs

Rachel Woods, Senior Consultant, Medical Group Strategy Council and Eliza Campbell, Senior Analyst, Physician Practice Roundtable

While the rankings on this Glassdoor list may not be overly surprising to many in health care, they grow more interesting when you compare them to Glassdoor's report from last year. While Glassdoor found that physician, pharmacy manager, and pharmacist salaries actually all decreased slightly between 2018 and 2019 (by 1.2%, 1.1%, and .04%, respectively), the salaries for physician assistants (PAs) and nurse practitioners (NPs) actually rose. PA salaries grew 4.7% in the past year, and NP salaries rose 2.4%.

The fact that these PA and NP salaries increased so much on Glassdoor's site while others stagnated indicates just how rapidly the market demand for them is growing.

Leaders of medical groups and health systems tell us that they are hiring Advanced Practice Providers (APPs) at a faster rate than ever before. In fact, leaders tell us every day that they expect APPs to be at least 50% of their medical group going forward. And as NPs and PAs become a larger percentage of the provider workforce, the competition to attract and retain top talent is heating up.

However, there's a challenge: APPs don't fit neatly into the practice model we've developed for physicians. Letting individual practices or physicians pilot APP deployment one-off diminishes ROI. For organizations to fully realize the financial and productivity gains that APPs have to offer, leaders must deploy and manage their APPs at scale. That means that individual physicians can't be the sole decision maker for how to deploy APPs (no, they aren't just physician extenders). If organizations want to get the full value out of APPs, they must adopt a group-wide model for deploying, training, evaluating, and providing leadership opportunities for APPs. To learn more about how to get the full value from your APPs, view our infographic here.

Now, of course, just looking at the yearly changes to compensation risks missing a bigger point with this list. The fact that five of the ten highest paid jobs in the United States are in health care shows why controlling labor costs continues to be such a pressing challenge for hospital and health system leaders. On average, labor costs account for around 75% of a hospital's total operating expenses. But cutting costs doesn't mean that leaders have to cut staff—in fact, clinical staff can be some of the best partners in hospital cost reduction.

To learn more about how physicians can help to rein in organizational costs, register for our upcoming webinar, How Physicians Can Help Rein in Costs, at 4 PM ET on September 24th.

Register for the Webinar

Then, to learn more about how nurse leaders can help identify savings opportunities, register for our webinar, 4 Ways Nurse Leaders Can Help Save Millions, at 3 PM ET on October 7th.

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