For Clinics · 6 min read · April 15, 2026
The cost of NP turnover is one of the most consistently underestimated line items in primary care practice management. When practice owners and medical directors think about the cost of losing an NP, they typically think about the recruitment fee — $15,000 to $25,000 for a search firm placement. But the recruitment fee is only the beginning.
The full cost of a single NP departure includes: the recruitment fee, the credentialing and onboarding costs for the replacement, the productivity gap during the transition period (typically three to six months of reduced revenue), the impact on patient continuity and patient satisfaction, the administrative burden on the remaining staff, and the morale impact on the team. When all of these costs are aggregated, the total cost of a single NP departure is consistently estimated at $40,000 to $60,000 — and in practices where the departing NP had a large, established patient panel, the number can be significantly higher.
"The cost of losing an NP is not the recruitment fee. The recruitment fee is the down payment. The full cost is two to four times that number."
The most effective prevention investment is clinical support — the combination of mentorship, case consultation, and ongoing education that addresses the primary drivers of NP departure. The practices that have made this investment consistently report lower turnover rates than those that have not, and the financial return on the investment is straightforward to calculate.
A clinical support program that costs $15,000 to $20,000 annually and prevents one NP departure per year generates a net return of $20,000 to $45,000 in the first year alone — before accounting for the productivity and quality benefits that the program also delivers.
The FNP Review offers clinical support partnerships priced to deliver a positive ROI from year one. If you are ready to stop paying the cost of turnover and start investing in prevention, we would love to help.