As Nurse Practitioners Rank the #1 U.S. Job, Pinch Builds a Business Around Them
When the American Association of Nurse Practitioners (AANP) announced that the nurse practitioner (NP) profession was once again ranked the top job in America in U.S. News & World Report’s 2026 Best Jobs rankings, one healthcare startup business owner wasn’t surprised.
Elan Mosbacher and Jacob Avraham, MD, built Pinch upon the needs of nurse practitioners. As a board-certified surgeon, Dr. Avraham witnessed firsthand the high rates of burnout among NPs during the pandemic. He turned to his friend and experienced startup executive, Mosbacher, to found Pinch as a way to offer NPs higher pay and a better quality of life.
From the start, the co-founders built their provider network exclusively around nurse practitioners. Now that Pinch is in seven states and soon to enter three more, their venture has proved successful. In an industry where most healthcare employers face staff shortages and burnout, Pinch typically receives more qualified applicants than positions to fill.
Their model shows that building a company strategically rooted in a positive culture, clinical training and the empowerment of experienced nurse practitioners creates better businesses.
How Pinch Solves NP Burnout Through Medical Aesthetics
Pinch’s founders didn’t start by asking how to build another med spa. Their idea started by asking NPs what they wanted from their careers.
“We spoke to many NPs and medical professionals in general. If you want more autonomy, mastery, purpose, earnings and you’re burned out of your traditional healthcare job, what do you want to do?” says Mosbacher.
Medical aesthetics was the response they heard more than any other.
Many clinicians described wanting more flexibility, greater autonomy, stronger earning potential and work that felt energizing instead of exhausting. “They want something that brings joy to people, where you can smile and laugh and have a good time, and isn’t quite as stressful,” says Mosbacher.
Aesthetics offered that perfect opportunity.
Rather than replacing hospital careers entirely, working with Pinch is a pathway to diversify income, regain schedule flexibility and practice in a setting centered on patient relationships and preventive wellness. “We offer a very low-risk way to dip your toe in the water and get as serious as you want to be without having to quit your six-figure healthcare job,” says Mosbacher.
Why Pinch Chose Nurse Practitioners Over PAs and RNs
While many aesthetic practices rely on registered nurses, physician associates and physicians working together, Pinch intentionally chose to work with nurse practitioners, who have both clinical expertise and broader autonomy.
“We ultimately landed on nurse practitioners as really a sweet spot,” he says.
That decision was based on several factors:
- Advanced clinical education and experience
- Full practice authority in many states
- Prescription authority in many states
- A regulatory framework that supports the company’s in-home care model
Scope of Practice Compliance: Pinch’s Competitive Edge
As the aesthetics industry continues to grow rapidly, it faces increased scrutiny from regulators and licensing boards. More providers entering the market raise questions about supervision, delegation and scope of practice.
Rather than viewing regulation as an obstacle, Pinch has treated compliance as a strategic advantage. When determining which states to launch Pinch, state regulations around NP authority have driven expansion decisions. “The number one filter is the regulatory environment,” says Mosbacher.
Before entering any new state, the company evaluates scope-of-practice requirements, corporate practice of medicine rules and supervision requirements to determine whether its model can operate safely and legally. In some markets, that means adapting its operations. In others, it means delaying expansion entirely.
Some compliance issues make it easier for Pinch to work with NPs over physician associates (PAs). NPs have more practice authority in many states. In Illinois, for example, a collaborating doctor can supervise an unlimited number of NPs but only seven PAs. “If you run a small medical practice with a few employees, 1:7 is totally fine. But if you want to build something at scale that empowers medical professionals around the country, that starts to create additional overhead and complexity,” says Mosbacher.
For healthcare entrepreneurs, Pinch a reminder that sustainable growth often begins with understanding the rules that govern clinical practice.
What Nurse Practitioners Want From Employers in 2026
Compensation matters, but Mosbacher believes it isn’t the only reason NPs are drawn to Pinch. Instead, he points to two other areas where Pinch invests heavily:
- Ongoing clinical education
- A strong provider community
The company developed a multi-stage training program that combines self-guided curriculum, in-person full didactic training, a supervised soft launch among family and friends to gain clinical experience and continuous quality review. “We have an edge on our competition because of our training. By the time a client books an NP on Pinch, there’s someone who has quite a bit of experience already and has done a great job enough times,” says Mosbacher.
Even after onboarding, providers receive ongoing feedback and support. Every Pinch treatment gets a review from the client, similarly to Uber or Airbnb. “Most of those reviews are excellent, but if there ever is an issue that’s flagged, we’re able to work with the client and provider to ensure a satisfactory outcome,” says Mosbacher.
Key Takeaways: Building a Nurse Practitioner Focused Healthcare Business
Pinch’s success as a business built for nurse practitioners isn’t simply a story about the growing popularity of medical aesthetics. It’s a model of how healthcare businesses can align business strategy with clinician needs.
The company’s model recognizes that today’s nurse practitioners are looking for more than a paycheck. They want autonomy, professional growth, meaningful work and organizations that invest in their success.
Organizations that understand scope-of-practice laws, prioritize compliance, invest in training and create environments where clinicians can thrive may be better positioned to compete for one of healthcare’s most in-demand professions.
Learn more about why NPs chose to work at Pinch.
Click here to learn about nurse practitioner professional liability insurance that protects NPs financially and professionally when a patient alleges negligence, error, or omission in the course of care.
Frequently Asked Questions
Why did Pinch choose nurse practitioners instead of physician associates or RNs?
NPs typically have full practice authority and prescription authority in many states, which gives Pinch more flexibility to scale its in-home aesthetics model without the supervision limits that apply to physician associates in certain states.
What is medical aesthetics, and why are NPs drawn to it?
Medical aesthetics includes services like injectables and skin treatments. Many NPs are drawn to it because it offers greater autonomy, flexible scheduling, and a lower stress alternative to traditional hospital or clinic work.
Do NPs need to leave their current healthcare job to work with Pinch?
No. Pinch is designed as a low risk way for NPs to diversify their income and gain experience in aesthetics while keeping their existing position.
How does Pinch ensure providers are properly trained?
Pinch uses a multi stage training program that includes self guided curriculum, in person didactic training, a supervised soft launch, and ongoing quality review based on client feedback.
How does regulatory compliance affect where Pinch operates?
Pinch evaluates scope of practice laws, corporate practice of medicine rules, and supervision requirements before entering any new state, and will delay expansion if the regulatory environment doesn’t support its model.
- NPs bring advanced clinical training and broader practice authority
- Compliance is treated as a strategic advantage, not a barrier
- Ongoing education and community support are core to the Pinch model
