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‍Key Findings from the 2024 Review

The 2024 Review is based on a representative sample of 2,138 permanent physician and APP search engagements conducted by AMN Healthcare's Physician Solutions division from April 1, 2023, to March 31, 2024. It revealed a clear picture of the current recruiting market. Unlike surveys tracking total compensation, this report focuses specifically on the incentives offered to attract providers to new positions.

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Several overarching trends stand out:

Salaries Generally Increasing: Average starting salaries for physicians and APPs were generally up year-over-year, with increases observed in 13 of the 20 tracked specialties. For APPs, the average starting salary for NPs increased by 8.6% year-over-year, from $151,000 to $164,000, and the average starting salary for CRNAs saw a substantial 31.6% increase, from $212,000 to $279,000.

NPs Still Top Demand: For the fourth consecutive year, Nurse Practitioners were the most requested search engagement by AMN Healthcare clients, highlighting their crucial role in meeting healthcare needs.

APP Searches Outpace Primary Care Physicians: AMN Healthcare now conducts more searches for APPs (NPs, PAs, CRNAs) (23%) than for primary care physicians (14%). While family medicine still ranks second overall among all search engagements and fourth for internal medicine, demonstrating robust demand, the relative demand compared to APPs and specialists has shifted.

Specialists Remain Highly Sought: Close to two-thirds (63%) of search engagements were for physician specialists, driven by the needs of an aging population. Specialties with high "Absolute Demand" (searches as a percent of practicing providers) include Hematology/Oncology, Gastroenterology, and Urology.

Incentives are Key: Beyond base salary (which is the focus of the average figures reported), various incentives are commonly offered. These include:

Signing Bonuses: Offered in 51% of engagements. The average signing bonus for physicians was $31,473, while for NPs and PAs it was $11,758.

Relocation Allowances: Offered in 55% of engagements. The average for physicians was $11,284, and for NPs/PAs it was $7,910.

CME Allowances: Offered in 89% of engagements. The average for physicians was $3,969, and for NPs/PAs it was $2,195.

Educational Loan Repayment: Featured in 17% of engagements. The average amount offered to physicians was $117,217, and to NPs/PAs it was $78,333.

Evolving Practice Settings: While hospitals remain a significant setting for recruitment (28%), medical group searches are up (26%), and urgent care/retail clinics/other settings saw a large jump (13% vs. 4% last year). Searches for solo/partnership/concierge practices also increased (6% vs. 2%). Academic Medical Centers accounted for 22% of searches, though down from previous years.

Recruiting is Widespread: Demand for physicians and APPs is not limited to rural areas, with 66% of searches conducted in communities of 100,000 or more people. AMN Healthcare conducted searches in 49 states.

Contract Structures: The most common contract structure remains a salary plus a production bonus (62% of searches), followed by a straight salary (32%). Production bonuses are primarily based on volume metrics like RVUs (57%) and net collections (13%), with quality metrics included in only 26% of contracts. When quality metrics are included, they typically determine only about 10% of total compensation (AMN Healthcare/Merritt Hawkins, 2024).

These findings underscore a healthcare market characterized by persistent shortages, an aging population driving demand, physician burnout and turnover, and increased competition from a growing number of diverse employers.

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Nursing Implications: Navigating Demand and Demonstrating Value

For Nurse Practitioners and other Advanced Practice Registered Nurses (APRNs), the 2024 Review offers a powerful affirmation of our value and a roadmap for career strategy. The consistent ranking of NPs as the #1 most requested search engagement for four years running speaks volumes about our indispensable role in filling healthcare gaps, particularly in primary care, where physician search activity has declined. This sustained high demand translates into tangible gains, as evidenced by the 8.6% increase in average starting NP salaries.

The report highlights the expanding roles of NPs, moving beyond traditional primary care into specialty medical practices (like dermatology, orthopedic surgery, gastroenterology, and cardiology) and non-traditional settings such as urgent care centers and retail clinics. This trend not only offers new career avenues but also allows us to leverage our skills in diverse clinical environments.

NPs are on the front lines of addressing critical access issues, comprising over 25% of primary care providers in rural areas and taking a larger role in mental healthcare delivery. Our growing contributions are directly mitigating shortages in underserved communities and mental health services.

Crucially, the report explicitly recognizes NPs as direct drivers of revenue. The data on NP billing to commercial payors, with a median of $777,393 annually, provides concrete evidence of our financial impact, even before including Medicare or government payors. This is a powerful data point for negotiating salaries, advocating for resources, or seeking to demonstrate value to employers and stakeholders.

For CRNAs, the 31.6% increase in average starting salary is a significant indicator of rising demand, fueled by the need for anesthesia providers in an aging population requiring more procedures. Their role is particularly vital in rural areas, where they are the majority of anesthesia providers (AMN Healthcare/Merritt Hawkins, 2024).

Understanding these trends empowers nurses to negotiate competitive packages, target high-demand specialties or settings, and articulate our value proposition not just clinically, but also economically, as essential revenue generators and access points for care.

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Implications for Aesthetic and Dermatology Nurse Practitioners & Entrepreneurs

High and Growing Demand for NPs Overall: The report indicates a very strong demand for Nurse Practitioners. NPs were the most requested search engagement for AMN Healthcare for the fourth consecutive year. The Bureau of Labor Statistics projects NP job openings to grow 45% by 2032, tied for the highest growth rate of any occupation. This pervasive demand suggests a strong underlying market need for NP services across healthcare, which could extend to specialized areas like aesthetics.

NPs Expanding into Specialty Care, Including Dermatology: The report notes that a growing number of specialty medical practices are adding NPs. It specifically mentions that NPs are mentored by specialty physicians to help provide services and patient education in areas like dermatology. Aesthetic practice often falls under or is closely related to dermatology. This trend suggests that the market is increasingly accepting and integrating NPs into specialized medical fields, which is a positive indicator for an aesthetic NP venturing out on their own.

NPs as Revenue Generators: The report explicitly states that NPs are direct drivers of revenue to their practices and employers. The AMN Healthcare 2023 Physician Billing Report tracked annual billing submitted by NPs to commercial payors, with the 50th percentile billing around $777,393 and the 75th percentile billing around $1,311,9228. While billing models in aesthetic practices might differ (e.g., more cash pay), the fact that NPs are recognized as significant revenue generators in other settings validates the potential for an NP-led practice to be financially viable.

Increasing Compensation Reflects Market Value: The average starting salary for NPs was up 8.6% year-over-year, from $151,000 to $164,000. While an entrepreneur doesn't earn a "starting salary," this increase underscores the increasing market value of NP skills and services. This is favorable for an NP entrepreneur, as it suggests the services we provide are highly valued in the market, potentially allowing for competitive pricing and strong revenue generation. It also provides a benchmark should NP entrepreneurs decide to hire other NPs in the future.

Uptick in Solo/Partnership/Concierge Practice Recruiting: Although still a small percentage (6%), the report notes an uptick in recruiting engagements for solo/partnership/concierge practice settings, up from 2% the previous year. This trend "suggests possible renewed physician interest in these practice settings. While this refers primarily to physicians, the context of practice ownership and bypassing third-party payers (as in concierge medicine, which shares some characteristics with cash-pay aesthetic practices) could signal a broader, albeit small, trend towards independent practice models that might also be relevant to NPs.

Competitive Landscape Includes New Entrants: The healthcare recruiting market is described as highly competitive, with various organizations, including retail chains, urgent care centers, telemedicine platforms, insurance companies, and private equity-owned medical groups actively recruiting physicians and APPs. Private equity companies have significantly expanded their presence in medical groups, often acquiring practices in high-revenue-generating specialties like dermatology and actively recruiting staff to grow these practices. This means an aesthetic NP entrepreneur would be entering a market with diverse competitors, including potentially large, well-funded entities.

Workforce Volatility and Burnout: The market is characterized by volatility and high turnover rates due to physician burnout. One-third of physicians cited burnout as the reason for leaving their organizations in 2021. This highlights challenges within traditional employment models. For an entrepreneur, this could present an opportunity to create a practice environment focused on well-being and autonomy, which might be attractive for both the entrepreneur and any future staff they might hire, potentially aiding in recruitment and retention in a competitive market.

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Detailed DNP Project Idea: Leveraging Recruitment Data for Retention Strategy

The 2024 Review points to significant workforce volatility driven by burnout and turnover, with 48% of physician searches in 2021 being replacements for departing physicians. This challenge isn't limited to physicians; APPs face similar pressures. A compelling DNP project could focus on leveraging the recruitment incentive data within the report to develop and implement evidence-based retention strategies for APPs, particularly NPs, within a specific healthcare system or practice setting.

Project Idea: Implementing a Data-Driven Retention Program for Nurse Practitioners Based on Competitive Recruitment Incentives

Problem: High NP turnover rates within [Specific Healthcare System/Practice Setting] lead to increased recruitment costs, decreased continuity of care, and negative impacts on staff morale and patient access. While competitive recruitment incentives are offered to attract new NPs, retention efforts may not adequately address factors beyond initial offers.

Purpose: To improve NP retention rates by developing, implementing, and evaluating a retention program informed by current, competitive recruitment incentives and reported reasons for provider departure (like burnout).

Objectives:

Analyze current NP compensation, benefits, and non-financial incentives offered within [Specific Healthcare System/Practice Setting] and compare them to the national and regional benchmarks provided in the 2024 Review for NP starting salaries ($164,000 average nationally, with regional variations), signing bonuses ($11,758 average for NPs/PAs), relocation allowances ($7,910 average for NPs/PAs), CME allowances ($2,195 average for NPs/PAs), and educational loan forgiveness ($78,333 average for NPs/PAs).

Identify gaps between current retention offerings and competitive recruitment packages/known drivers of turnover (e.g., burnout, lack of professional development, inadequate support).

Develop a comprehensive NP retention program proposal that strategically incorporates competitive elements (e.g., retention bonuses benchmarked against signing bonuses, increased CME allowances, enhanced professional development opportunities, support structures to mitigate burnout) and is tailored to the specific needs identified within the target setting.

Implement key components of the proposed retention program within a pilot group of NPs over a defined period (e.g., 6-12 months).

Evaluate the impact of the pilot program on NP retention rates, job satisfaction (using surveys informed by potential reasons for departure), and perceived value/support, comparing findings to baseline data and potentially a control group if feasible.

Significance: This project directly addresses workforce instability by using concrete market data to inform retention strategies. By ensuring that ongoing support and incentives are competitive with what's being offered to attract new talent, the project aims to create a more stable and satisfied NP workforce, ultimately improving patient care and organizational efficiency. It translates the report's macro-level data into a micro-level, actionable intervention within a specific clinical environment.

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PhD Nurse-Led Research Opportunity: Examining the Impact of Evolving Practice Settings

The 2024 Review highlights a notable shift in where physicians and APPs are being recruited, with increases in medical groups, urgent care/retail clinics, and even solo/concierge practices, alongside a decrease in hospital and academic medical center search engagement percentages. This trend raises important questions about the long-term impact of these evolving practice models on APP practice, autonomy, and patient outcomes.

Research Question: What is the impact of employment setting (e.g., hospital-based, corporate-owned medical group, urgent care/retail clinic) on Nurse Practitioner scope of practice, perceived autonomy, job satisfaction, and patient outcomes in [Specify a clinical area or population relevant to the report's findings, e.g., primary care, mental health, specific specialty noted in the report]?

Background: The report indicates a significant shift, with 77% of physicians now employed by hospitals, health systems, or other corporate entities, and notable increases in recruitment to corporate-owned medical groups (up 86% between 2019-2022), urgent care/retail clinics (up from 4% to 13% of searches), and a slight uptick in solo/concierge settings (up from 2% to 6%). This contrasts with the historical dominance of physician-owned practices, which have dwindled. While the report tracks recruitment to these settings, it doesn't detail the experience or impact of practice within them.

Research Design: A mixed-methods approach could be employed.

Quantitative data in primary care and mental health: Survey NPs practicing in different settings (e.g., hospital-employed, corporate medical group-employed, urgent care/retail, independent/concierge) to assess their perceived scope of practice, autonomy (using validated scales), and job satisfaction. Analyze aggregated patient outcome data (if accessible and comparable across settings) for specific conditions managed by NPs in these settings (e.g., HbA1c control in diabetes, hypertension management, mental health symptom reduction).

Quantitative data in aesthetics:

Complication rates across injectors (e.g., comparing rates of post-filler vascular occlusions, bruising, or nodules across multiple NPs or practices).

Patient satisfaction scores after cosmetic procedures (e.g., survey data aggregated from 500+ Botox patients rating satisfaction with results, pain, downtime, natural look, etc.).

Skin quality improvement scores after treatments (e.g., VISIA imaging results measuring wrinkle depth, pigmentation, or pore size improvements across microneedling or laser patients).

Treatment efficacy for acne scarring across different NP techniques (e.g., comparing average scar depth reduction using microneedling + PRP versus CO2 laser).

Longevity of aesthetic outcomes (e.g., patient-reported duration of Botox effectiveness across different muscle groups or injection techniques).

Rates of retreatment or touch-ups needed (e.g., tracking how often patients need an early Botox or filler touch-up compared to standard intervals).

Qualitative: Conduct semi-structured interviews with a subset of NPs from each setting to explore their experiences regarding clinical autonomy, collaborative relationships with physicians and other team members, administrative support, opportunities for professional development, and perceived impact on patient care quality and access.

Potential Findings: The research could reveal if NPs in corporate-owned or urgent care settings experience different levels of autonomy or scope compared to hospital-based or independent practice, potentially linked to productivity metrics emphasized in contracts (e.g., RVUs). It could also explore how these differences influence job satisfaction and whether variations in practice models impact patient outcomes or access to care, particularly in high-demand areas identified by the report (like primary care or mental health).

Significance: This research would provide crucial evidence on how the changing landscape of healthcare employment impacts the NP workforce and patient care. By understanding the strengths and challenges associated with different practice models, findings could inform policy, practice guidelines, and educational curricula to optimize NP utilization and ensure high-quality, accessible care across diverse settings. It translates the report's recruitment location data into an inquiry about the practice environment and its outcomes.

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Recommendations for Entrepreneurs: Seizing Opportunity in Evolving Healthcare Delivery

The 2024 Review reveals several shifts in the healthcare landscape that present compelling opportunities and challenges for nurse entrepreneurs and innovators. The rise of new employer models and the dynamics of talent recruitment offer insights for those looking to build sustainable, impactful healthcare ventures.

Address Pain Points in Growing Settings: The significant increase in recruitment by medical groups (including private equity-backed) and urgent care/retail clinics indicates these are areas of growth and investment. Entrepreneurs could develop solutions or services tailored to the specific needs of these entities. For example, given the continued reliance on volume-based production bonuses (like RVUs) in many contracts, entrepreneurs could create technology solutions or consulting services that help practices optimize workflow, documentation, and billing processes to enhance NP productivity and revenue generation (mirroring the billing data for NPs). Or, recognizing the challenge of integrating APPs into specialty practices, offer consulting or educational services focused on effective APP onboarding and collaborative practice models.

Empower NPs in Independent/Concierge Models: The uptick in search engagements for solo/partnership/concierge practices suggests a potential renewed interest in independent practice, especially concierge models that bypass third-party payers. Entrepreneurs could develop support services specifically for NPs interested in establishing their own independent or concierge practices. This could include business coaching, legal and regulatory guidance (especially concerning Full Practice Authority states), marketing support, or technology platforms designed for direct-pay patient relationships. This aligns with empowering nurses to pursue entrepreneurial paths.

Innovate to Address Shortages Beyond Recruitment: While recruitment data shows demand, the underlying issue is a shortage of providers and burnout. Entrepreneurs can develop innovative care delivery models that maximize the efficiency and impact of existing providers, particularly NPs in areas of high demand like mental health, rural care, or specialties like dermatology. This could involve tech-enabled solutions for remote patient monitoring, virtual care platforms that streamline visits, or care coordination services that offload administrative burden from providers, thereby combating burnout and improving retention – a critical need highlighted by the report.

Leverage Data for Strategic Advantage: The detailed compensation and incentive data in the 2024 Review is a powerful tool. NP entrepreneurs building staffing agencies, consulting firms, or new practice models should use this data as a benchmark to ensure your compensation and benefit packages are competitive, attracting top talent in a highly competitive market. Understanding which incentives are customary (like CME and benefits) and which are less common but highly valued (like educational loan forgiveness) can inform smart talent acquisition strategies.

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Summary

By closely analyzing the trends in recruitment destinations, compensation structures, and the underlying drivers of workforce volatility outlined in the 2024 Review, we can identify fertile ground for innovation, develop services that solve real problems for providers and employers, and empower the healthcare workforce in new ways. The report paints a clear picture of a robust and growing market for nurse practitioners, with increasing value placed on our services and expanding opportunities in specialty areas like aesthetics and dermatology. While the competitive landscape includes large corporate players, there are also signs of renewed interest in independent practice models. The demonstrated revenue-generating capacity of NPs further supports the potential viability of an entrepreneurial venture in aesthetics, provided we can navigate the competitive environment and capitalize on the demand for our specialized skills.

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This exploration of the 2024 Review underscores that the healthcare recruitment market is a dynamic ecosystem, constantly shaped by supply, demand, economic pressures, and evolving models of care. By transforming these complex data points into accessible conversations and actionable insights, I aim to empower healthcare professionals and entrepreneurs alike to navigate this landscape strategically, advocate for our value, and continue driving positive change in healthcare delivery—one conversation, one decision, one innovative venture at a time.

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Reference

AMN Healthcare/Merritt Hawkins. (2024). 2024 review of physician and advanced practitioner recruiting incentives: An overview of the salaries, bonuses, and other incentives customarily used to recruit physicians, physician assistants, nurse practitioners and CRNAs. AMN Healthcare.

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Kimberly Madison, DNP, AGPCNP-BC, WCC

I am a Board-Certified Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research, I aim to expand access to dermatology research, business acumen, and innovation using artificial intelligence and augmented reality while also leading professional groups and mentoring clinicians. Through engaging and informative social media content and peer-reviewed research, I empower nurses and healthcare professionals to excel in dermatology and improve patient care.

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