economics Paradigm Challenge

Giving nurse practitioners more independence is backfiring: they're actually choosing shorter degree programs and spending less time in school.

March 27, 2026

Original Paper

Occupational Autonomy and Human Capital Investment: Evidence from Nurse Practitioner Practice Authority Reforms

Kihwan Bae

SSRN · 6351539

The Takeaway

We usually assume that increased professional responsibility requires more education. However, once a master's degree is legally sufficient to run a private practice, the extra years required for a doctorate become an unnecessary expense with no additional career return.

From the abstract

Regulatory reforms can permanently change the economic returns to education. This paper studies whether individuals adjust costly educational investments when regulatory reforms durably alter occupational autonomy and earnings. I examine staggered adoptions of full practice authority (FPA) laws for nurse practitioners (NPs), which increase legally defined job autonomy and expected returns to NP training. Using institution-level data on graduate nursing degree completions, I find that FPA increas