Why would anyone care about becoming a Family Nurse Practitioner (Family NP or FNP)?
Haven’t you heard? Medical students are running away from the specialty of family medicine because the field doesn’t pay enough ($219,000 annually, to be exact). Guess who is expected to fill the “family practice gap?” Yes, the Family NP.
Just how big of a player will you be as a FNP? Here’s a breakdown of the number of different players in family practice:
The total number of family practice clinicians (doctors, NPs, and PAs) is 198,790. Using our 94,464 stat above, we know that FNPs comprise at least 47.5% of the players in the family practice realm right now.
Take a moment and think about what I just said. That’s right: FNPs represent ALMOST ONE-HALF of the prescribing workforce in family practice. Do you think they might play a role in primary care?
Then let’s get to business.
How much money does a FNP make?
According to 2019 data at Glassdoor.com, FNPs make an average of $117,292 per year.
What’s the difference between the work of a FNP and that of a family medicine doctor?
Short answer: the difference lies more in who is providing the “family care.” If the FNP is providing care, the service is called nursing. If the doctor is providing care, then the service is called medicine.
Long answer: I don’t think it’s possible to answer this question (without giving vague generalities) because family practice providers work in such different environments. Plus, FNPs are not uniformly regulated, so their functions depend on their respective state laws. But I’ve tried to keep things simple with broad job descriptions.
According to Nursejournal.org, FNPs are qualified to do the following tasks:
- Manage chronic conditions, like hypertension and diabetes
- Oversee the health and wellness of pregnant women, including providing preconception and prenatal care
- Provide health and wellness care to infants and children
- Treat minor acute injuries
- Provide episodic care for acute illnesses in all age groups
According to the same site, “typical duties include diagnosing conditions, ordering and interpreting diagnostic tests, conducting examinations, providing counseling, and sometimes prescribing medications.”
How about the MD side?
According to Onenet, family doctors do the following:
- Immunize patients
- Prescribe medications
- Prescribe treatments or therapies
- Analyze test data or images to inform diagnosis or treatment
- Collect medical information from patients, family members, or other medical professionals
- Order medical diagnostic or clinical tests
- Record patient medical histories
- Monitor patient progress or responses to treatments
- Explain medical procedures or test results to patients or family members
- Advise communities or institutions regarding health or safety issues
- Provide health and wellness advice to patients, program participants, or caregivers
- Refer patients to other healthcare practitioners or health resources
- Care for women during pregnancy and childbirth
- Collaborate with healthcare professionals to plan or provide treatment
- Supervise patient care personnel
- Operate on patients to treat conditions
- Design public or employee health programs
- Direct healthcare delivery programs
- Train medical providers
- Prepare official health documents or records
- Conduct research to increase knowledge about medical issues
According to the American Academy of Family Physicians, the job responsibilities of family physicians are:
- Care for patients regardless of age or health condition, sustaining an enduring and trusting relationship
- Serve as a patient’s first contact for health concerns
- Navigate the health care system with patients, including specialist and hospital care coordination and follow-up
- Use data and technology to prioritize and coordinate services, enhancing access, continuity, and relationships
- Care for patients in the context of their family and the ways in which the health of each family member affects the others
- Understand the effects of community-level factors and social determinants of health, helping patients to identify community resources available
The take home message is that family practice providers do many things. The specific job responsibilities of the provider depend on the facility in which one works.
What personality traits do I need in order to excel in the FNP role?
According to Onetonline.org, there are three defining attributes of the FNP:
- Social – (Do you like talking to people? Do social situations energize you? Or do they take away your energy?)
- Investigative – (Do you like working with ideas? In your free time, do you search for facts or try to figure out problems mentally?)
- Realistic – (Are you a hands-on person when it comes to problems?)
According to Sacred Heart University, there are four common traits for a FNP:
- Good communicator
If we had to pick a Myers Brigg label for the ideal FNP, it looks like it would be the ESTJ.
What degree do you need?
As of 2019, one needs a master’s degree or a post-graduate certificate.
What EXACTLY DO I NEED to get a FNP job?
-A Nurse Practitioner certificate issued by your state’s Board of Registered Nursing (BRN)
-A Nurse Practitioner medication furnishing number issued by your state’s BRN
-A license to practice as a Registered Nurse issued by your state’s BRN
-A Controlled Substance Registration Certificate issued by the United States Department of Justice Drug Enforcement Administration (DEA), assuming you want to prescribe controlled substances
-Certification as a Family Nurse Practitioner (FNP-BC) issued by the American Nurses Credentialing Center OR Certification as a Family Nurse Practitioner (FNP) by the American Academy of Nurse Practitioners
-National Provider Identification Number (NPI)
-Possibly BLS and ACLS certifications
(I looked up FNP job requirements on Indeed.com and coalesced information from ten different postings)
All these requirements assume you will graduate from an accredited graduate program with a FNP focus. Whether you need a DNP or master’s degree will depend on the specific job.
What kind of work experience is required to get into graduate school?
The safe bet is to get two years of work experience as a nurse. Because the nature of family practice is primary care, any nursing job will probably be deemed “good enough” in the eyes of an admission committee. In other words, you don’t need acute care experience to get into a FNP program. Nursinglicencure.org put it best: “primary care tends to be the most friendly to those whose careers have been built on the basis of something other than direct patient care.” So when it comes to getting admitted to FNP programs, the type of work experience you have is less important than just having work experience.
But if you’re the type of person who likes shortcuts or enjoys getting straight to the point, I would say that work experience is NOT required. At the end of the day, you will simply need to meet the requirements for graduate admission (you can find out the minimum requirements by calling the school in question), and you will be admitted if the competition is low. It is not difficult to gain admission into FNP programs. Half of NPs today specialize in family practice.
So if you have no work experience and want to be a FNP, then all you need to do is apply to as many FNP programs as you can afford, and you will probably get into at least one program. However, I recommend getting work experience (to confirm you can stand being a nurse) before applying to FNP programs. That way, you’ll gain some knowledge about nursing and save a lot of money on applications.
What’s the deal with Family NP residency programs?
Family NP residency programs typically offer 12-18 months of formal post graduate training to help newly minted NPs feel comfortable in their new roles. As of this writing, these residency programs are not necessary for the typical FNP to secure a job.
So what do national organizations have to say about these residencies? The Nurse Practitioner Roundtable, a group of professional organizations of which the American Association of Nurse Practitioners (AANP) is a member, offers this assessment: “Additional post-graduate preparation is not required or necessary for entry into practice.”
A google search for FNP residencies yielded the following results:
–12 month salaried residency in Connecticut with benefits, followed by a year of employment at Community Health Center, Inc.
–12-month program in California provides intensive training in both the clinical complexity of family practice in the safety net setting and training in a high performance, PCMH model for primary care.
–18 month program in California labeling itself as the first accredited FNP Residency in the nation.
So should you bother with a Family NP residency or not? The bottom line is that spending a year in a residency program will reduce your earnings in your first year, since residencies typically pay anywhere from one third to one half of a typical NP salary. Coincidentally, the first year out of school is the very year many NPs expect to have a six digit income.
If you are concerned with professional growth, the Family NP residency is probably for you. If you are more concerned with the bottom line and maximizing your lifetime earnings, you should pass on the Family NP residency.
What does the literature have to say about the safety of Family NPs?
“The historical studies and recent literature provide little reason to suspect that there is a difference between APRN care and physician care in primary and urgent care settings with regard to health status, quality of life, mortality, or hospitalizations.”
“Nurses trained specifically to resolve acute health problems of low complexity give comparable quality of care to that provided by general practitioners in terms of resolution of the problem 15 days after the visit and in patient satisfaction with the visit.”
“In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients’ outcomes were comparable.”
Conclusion: Are Family NPs safe? They probably are, and you probably won’t die after seeing a Family NP. Are Family NPs just as safe as Family MDs? Nobody knows, but there is no evidence that Family MDs are safer than Family NPs.