The physician shortage isn't a forecast anymore. It's a staffing plan. The AAMC projects that the United States will face a shortage of up to 86,000 physicians by 2036 [AAMC]. At the same time, the Bureau of Labor Statistics projects nurse practitioner jobs will grow 41% and physician assistant jobs 21% from 2025 to 2035 [BLS: NPs, BLS: PAs].
Put those numbers side by side and the direction is clear. A growing share of patient care will be delivered by advanced practice providers. Many health systems already rely on them in primary care, emergency medicine, hospital medicine, anesthesia, and surgical services.
Yet most staffing programs were designed around physicians. Requisition templates, credentialing checklists, rate cards, and vendor relationships all assume a physician on the other end. APPs get squeezed into a process that wasn't built for them, and that's where coverage, compliance, and cost start to slip.
This guide covers why advanced practice provider staffing deserves its own strategy, where physician-built models break down, and how to build a program that fits the APP workforce you actually have.
The scale has changed quickly. The American Association of Nurse Practitioners reports that the profession has grown to more than 461,000 licensed NPs nationwide [AANP]. On the PA side, NCCPA counted 201,038 board certified PAs at the end of 2025, a 5.9% increase from the year before [NCCPA].
These clinicians aren't concentrated in one corner of the hospital. According to NCCPA, surgical subspecialties are the largest practice area for PAs at 18.3%, followed by family medicine and general practice at 15.9% and emergency medicine at 10.4%. That spread matters, because it means APP staffing decisions are happening in almost every department, often without a shared view of cost or coverage.
Treating APPs as "physicians, but cheaper" creates predictable problems. Here's where the differences show up.
| Physician staffing | APP staffing | |
|---|---|---|
| Scope of practice | Set largely by privileges | Set by privileges and state law, which varies widely |
| Supervision | Not typically required | Collaborative or supervisory agreements may be required, depending on the state |
| Credentialing | Specialty board and privileging | National certification, state authority, delineated privileges and agreements |
| Career mobility | Specialty changes are less common | Often moves between specialties over a career |
| Rates and requisitions | Built into most vendor rate cards | Frequently handled ad hoc, department by department |
Scope of practice is the big one. It's defined state by state, and AANP maintains a state practice environment map because the rules differ so much across the country [AANP]. A staffing model that moves APPs across state lines or facilities without tracking those rules is a compliance risk waiting to surface.
Career mobility is another. NCCPA found that 52.7% of practicing PAs have changed specialties at least once [NCCPA]. That flexibility is a strength, but it also means your credentialing and competency verification need to follow the specialty, not just the person.
Many organizations lean on locum physicians but rarely think about contingent APPs. The gap has a long history. In a Staff Care survey from 2017, 26% of healthcare facility managers said they had used locum tenens NPs or PAs in the previous 12 months, compared with 94% who had used locum physicians [AMN Healthcare].
That data is dated, and APP use has grown since. But the pattern still shows up in how programs are built. Nurse practitioner locum tenens and physician assistant staffing are often sourced one-off by individual departments rather than managed as part of the contingent workforce. That makes it hard to answer basic questions: How many contingent APPs do we have? What are we paying? Which vendors fill APP roles fastest?
Start with where APPs already work and where gaps keep appearing. Hospital medicine, emergency departments, anesthesia, surgical services, and primary care often have very different needs, schedules, and supervision models.
Create requisition templates and credentialing checklists designed for NPs, PAs, and CRNAs. Include certification, state authority, collaborative or supervisory agreement requirements, and delineated privileges, so nothing is bolted on after the fact.
If you operate in more than one state, make scope-of-practice rules part of the staffing workflow. The right APP for a role in one state may need a different agreement, or may not fit the role at all, across the border.
Nurse practitioner locum tenens and contingent PAs should flow through the same requisition, vendor, and billing process as locum physicians. That's how you get consistent rates, clean compliance, and real visibility into spend.
Specialty mobility can work in your favor. Clear pathways between departments, flexible schedules, and internal float opportunities help you keep experienced APPs inside the organization instead of losing them to outside roles.
APPs don't need a separate system. They need a system that treats them as a core part of the workforce. Ringo manages locums, nursing, allied health, APP, and nonclinical staffing in one place, so NPs, PAs, and CRNAs sit alongside the physicians and nurses they work with every day.
For APP recruitment teams, that means a clear view of every open role, every file, and every vendor. For finance, it means APP labor finally shows up as its own line instead of an afterthought. For related reading, see what healthcare CFOs should know about the CRNA shortage and how to shorten locum tenens credentialing.
Advanced practice providers are no longer a supplement to the physician workforce. With physician supply tightening and NP and PA roles growing much faster than the workforce overall, they're a central part of how care gets delivered.
Staffing models need to catch up. That means APP-specific requisitions and credentialing, scope-of-practice rules built into the workflow, and contingent APPs managed in the same program as locum physicians. The organizations that make that shift will fill roles faster, stay compliant, and see exactly what their APP workforce costs.
Ringo is the leading vendor-neutral workforce management platform purpose-built for healthcare, managing locum tenens, nursing, allied health, APP, and nonclinical staffing in one place with no agency affiliations. Ringo earned a 94.2 overall satisfaction score in the KLAS 2025 First Look Report, with 100% of interviewed customers saying they would buy again.
Advanced practice provider staffing covers how health systems recruit, credential, schedule, and pay nurse practitioners, physician assistants, CRNAs, and other APPs, including both employed and contingent providers such as nurse practitioner locum tenens.
The Bureau of Labor Statistics projects nurse practitioner employment will grow 41% and physician assistant employment 21% from 2025 to 2035. AANP reports more than 461,000 licensed NPs, and NCCPA counted 201,038 board certified PAs at the end of 2025.
APP credentialing typically includes national certification, state licensure and practice authority, delineated privileges, and in many states a collaborative or supervisory agreement. Because scope of practice varies by state, those requirements should be built into APP-specific checklists.
Yes. Running contingent NPs and PAs through the same requisition, vendor, credentialing, and billing process as locum physicians gives you consistent rates, cleaner compliance, and a clear view of total contingent provider spend.
A STAFFING MODEL BUILT FOR APPs
Your hospitalist group needs two NPs by next month. Where do you start?
In a physician-built program, that request becomes a scramble. The requisition template doesn't fit. The credentialing checklist is missing the collaborative agreement. One department calls its usual agency, another calls a different one, and finance won't see the cost until the invoices arrive.
With Ringo, the same request runs like any other. NPs, PAs, and CRNAs are managed right alongside your physicians, nurses, and allied staff on one vendor-neutral platform. Every approved agency sees the requisition at once, credentialing starts the moment a candidate is submitted, and APP spend shows up as its own line in your reporting. Because Ringo owns no staffing agency, every supplier competes fairly.
Your APP recruitment team gets a clear view of every open role. Finance gets the full picture. Your patients get covered sooner. It's part of why Ringo earned a 94.2 overall satisfaction score in the KLAS 2025 First Look Report, and 100% of interviewed customers said they'd buy again.
See how Ringo brings your APPs, physicians, and nurses into one staffing program.