Does Working in a Nurse Practitioner Specialty Leave You Pigeon-Holed?

Specialty positions abound for nurse practitioners and physician assistants. Interested in cardiology? No problem. Have a bent for oncology? There’s a position out there for you. Specialty positions allow NPs and PAs to hone in on their interests and become experts in a focused area of medicine. Despite the draw of these types of job opportunities, some providers worry that accepting a specialty position will pigeon-hole them, limiting options for expanding their practice in the future.

The concern that focusing your practice area, particularly early in your nurse practitioner career, will leave you pigeon-holed is legitimate. The ‘use it or lose it’ philosophy certainly applies to medical knowledge. Family nurse practitioners, for example, accepting positions in adult neurology aren’t likely to feel comfortable treating pediatric otitis a few years out of the field. Committing to a specialty position, however isn’t a death sentence when it comes to options for future career transitions.

Think through the level of knowledge overlap

Primary care is the foundation for nearly every medical field. Even if you focus on a particular nurse practitioner specialty, you’re likely to keep a foot in the primary care realm. Oncology nurse practitioners to name a specialty, treat complications of cancer, for example pneumonia and DVT. These diagnoses are also likely to present in primary care, making the transition back to a broader scope of practice less stressful.

Nurse practitioners practicing in specialties also treat patients with multiple comorbidities helping them keep up with internal medicine know-how as a whole. Cardiology patients may have concurrent diabetes keeping heart-disease NPs in the know when it comes to diabetes management. If you’re concerned about your ability to switch practice areas later in your career, consider the level of overlap your specialty of choice has with other interests. If the two are related, taking a career leap is a practical future step.

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Maintain realistic expectations of a future job search

Working in a highly specialized position doesn’t necessarily preclude nurse practitioners from practicing in another specialty at a later date. But, it can make the job search more difficult. Maintain realistic expectations should you choose to search for a new opportunity in an unrelated area. Despite your years of experience, your search may look more like one of a new graduate. Allow plenty of time to find a new job working in a nurse practitioner specialty different than the one in which you are experienced.

Understand your specialty’s reputation

In a similar vein, the specialty in which you choose to work has a direct impact on your future job prospects. Right or wrong, experience in certain practice areas isn’t looked upon by prospective employers as favorably as others. Five years of experience working in a weight loss clinic prescribing phentermine won’t get you very far. Answering calls for an insurance carrier rather than treating patients face-to-face won’t count for much on your resume application for a clinical position.

Consider keeping a foot in the door

If you’re a commitment-phobe when it comes to selecting a practice area, we don’t blame you. You’ve worked hard to obtain a well-rounded nurse practitioner education. Using a limited portion of your knowledge can seem like selling yourself short. So, keep a foot in the door. There are plenty of PRN positions open to nurse practitioners, particularly in the primary care realm. Pick up a shift or two each month to keep your clinical know-how fresh outside of your specialty of interest.

Whether you are looking for a position as a primary care or specialty nurse practitioner, ThriveAP Career Advisors are happy to help. Contact a Career Advisor for free, personalized job search assistance!


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