which is the case for many MD/DOs as well these days.

So they're employed by someone trying to milk whatever production they can get out of them. PA/NPs are generally capped income-wise with limited to no bonus opportunities, few raises, etc. So it's a great job for a solid 125-150k a year but you have basically zero upward mobility from there. Basically they're just hourly workers with most averaging about $60-70 bucks an hour regardless of what they produce or bill.

Basically in medicine the only way to make a high income is based on volume - you get paid the same for taking 60 minutes vs. 15 (hence why your time with your provider shrinks by the year).. or it's based on the downstream value you bring to a system (basically they pay you x amount so that you can direct them all the business that pays the bigger bucks).

So it's extremely rare for any provider in medicine to get a large hourly payout on any patient for any activity. If I do a high-risk complex life/death type procedure at 2 am, I'm still not getting $900 bucks for that. But if I can do that procedure in 15 minutes and then crank out seeing two other patients and read 5 imaging studies then sure that hourly rate rises.