Are FNP salaries in family practice really this low?

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Currently receiving offers as a new grad FNP in family practices (wealthy areas and poor areas) for $60,000 to 70,000 salary (non hourly rate) with poor benefits/bonuses in Philly and surrounding suburban areas...includes weekly call and contracts that require a year or more of commitment. I'm told reimbursement rates are low in these counties and that's why the salaries are like this for NPs. Is this typical right now due to the economy or am I being taken advantage of as a new grad? Will things get better in January with ACA insurance coverage? Better salaries and benefits? I'm really shocked at the salaries. I can't accept something low. Super discouraged. Any advice out there????

Specializes in Mental Health.

75k is way too low. If that's the case, I really hope NPs in FL start negotiating more. There's no way that reimbursement rates are that low in FL so someone is profiting from these NPs

Specializes in Adult Internal Medicine.

Florida has one of the most restrictive practice laws as well. Hope the local and national organizations are pushing for changes.

Specializes in Home Health, Podiatry, Neurology, Case Mgmt.

I"m part of the FL nurses association and they have been trying for a LONG time to get restrictions lifted. FNPs are glorified RN's here, not looked at (at least in MY opinion) as collaborative providers. I"m just starting school so I'm hoping by the time I'm finished there will be some major changes! =) I do work with one FNP who works with a private managed care company and she was started out 2 yrs ago as a new grad at 100K, that too me seems more realistic as she does EVERYTHING that the physician does in the same office.

I"m part of the FL nurses association and they have been trying for a LONG time to get restrictions lifted. FNPs are glorified RN's here, not looked at (at least in MY opinion) as collaborative providers. I"m just starting school so I'm hoping by the time I'm finished there will be some major changes! =) I do work with one FNP who works with a private managed care company and she was started out 2 yrs ago as a new grad at 100K, that too me seems more realistic as she does EVERYTHING that the physician does in the same office.

You are right about Florida and I also hope when i'm done with school this will no longer be an issue.

Specializes in Pain Management, FNP, Med/Surg, Tele.

I am just renewing my FL state ARNP license because I am moving down there by the end of 2015. I really do hope some of these restrictions are lifted soon because I would like to practice at the full scope of my training. I am going to find it really challenging coming from NYC where I'm allowed to do almost everything to FL where I'm going to hear no you can't do that. I'm already getting a bad taste in my mouth because I went on the Florida health website and could not find the NP option to renew. I called them up and I was told by 2 different representatives to just select the RN option because NP is the same thing as RN, it's just an upgrade. I almost fell off the chair when they said that. The last time I checked I had to go back to school for 3 more years after getting the 4 year RN degree so I don't understand how RN and NP are the same thing. Also, RNs can't diagnose, treat and they don't have prescriptive privileges. I don't know...

ARNP salary is contingent on a few variables. Unfortunately, a glut in the market since the addition of "sit at home in our jammies" online degree courses has been painful for our salary, and will only get worse.

1) Online programs are already getting a reputation for churning out low quality. We have interviewed a large number of ARNP grads. Most think like a nurse, and want to be a nurse. Joining a practice is becoming part of a business. That means long, hard hours, dedication and self-direction.

2) As a business, keeping costs low increases your bottom line. When there are a glut of ARNP's to choose from, someone will usually take a low offer. Smarter ARNP's are willing to start low for the experience. Believe me, sitting in an ICU job as an ARNP may be paying the bills, but doesn't bring anything to the table.

3) Private practice can pay whatever they want. I know NP's making easy 6 figures. It's all about revenue.

4) Most NP's joining a practice are a burden on the practice for a long time. Despite what we believe about our skills, many practices find it challenging to add a practitioner. Patients who are established don't want to change. Why would they? So a new NP has to build their practice from new patients, hospital follow up, or emergent visits. This takes time.

5) Or you can try to get an institutional job (ICU, physician extender, or whatever). Hospitals are adding NP's, and usually pay a scale slightly higher than an experienced RN. But again, the experience is priceless.

Edit:

6) And your reputation is usually known if you stay in the same area. This may not apply to everyone, but many nurses who are working start looking for work in their own backyard (physicians they know). This can help or hurt salary negotiations. Sometimes it is better to strike out to a new area, especially if your last few years as a nurse have been kind of "disgruntled". A practice doesn't want your baggage.

Specializes in Pain Management, FNP, Med/Surg, Tele.

Hi AutomotiveRN67,

I totally agree with everything you said, I personally feel a bit disgruntled about those online degree programs because I chose to go to a traditional program for all 3 of my degrees. I sat in class for 4 years for the BSN, 2.5 years for the MSN and now I'm finishing up the 3.5 it takes for the DNP. I feel highly offended that someone else can just sit at home for a few months it seems and get the same title and salary as me. Kind of like the get rich schemes. Don't get me wrong, I understand everyone has their own situations and have to do what they have to do but still.

Salary, now that's another case on it's own. I still believe a lot of employers and Physicians just see the word "Nurse" when they look at the title NP. You could explain what it is and the scope of your practice until you are blue in the face but all they can see is a glorified Nurse so that's how they treat and pay you. They understand what a PA is so they will turn around and reimburse them more than they do an NP. (I have nothing against PA's I have been working with them throughout my entire career as a team, colleagues and friends).

Finally, let's not get me started on the "Physician Extender" and "Mid-Level Provider" titles. I normally don't use this word but I "HATE " those terms. How dare you call me that when I do everything (minus the few things the AMA keeps fighting) that a "Physician" does. I understand I didn't go to med school but I didn't want to be a Physician, I wanted to become a Nurse. I wish they would stop feeling threatened by us.

Specializes in Internal Medicine.

I love seeing nurses belittling other nurses simply because they went to school online. Correct me if I'm wrong, but there isn't any research out there that states that an NP that goes to a brick and mortar school is clinically superior to an NP that got their education through an online program. Whether you go to school online or not, you are still required to do clinicals with real people and real patients for a minimum number of hours that is mandated by each state for licensure. If online schools were so unsafe or inferior, why would any nursing organization or state in the union accredit them?

This form of argument between online versus in person schooling is so similar to the bologna physicians try to throw at APRN's about their superior education. Yeah, so what that you went to a 4 year medical school plus 3 years of residency, your outcomes are identical to an APRN. Who cares if you sat there for lectures in person versus doing it online, the outcomes are also no different. It's jealousy and trying to keep others down because one group feels they are superior, plain and simple.

Aside from that, NP salary like anything else is largely dependent on market and specialty. Simple supply and demand. My market pays handsomely, and physicians treat us well. Almost every classmate that I graduated with here in Texas had a great job offer hovering around 6 figures, fresh out of school because our market isn't saturated.

Specializes in Pain Management, FNP, Med/Surg, Tele.

Riburn3, I am by no means jealous of anyone, what they have or how they chose to live their lives I continue to do what I want because I make my own decisions in this life. I make 6 figures as well and had the time, money and support to go to school for 10.5 years in a "brick and mortar" school.

Physicians do not go to an online program to become an MD so why should an NP go to an online program to become a viable NP. Online programs are one of the main reason why Physicians do not have any faith in our competency. Why should they trust that a 2 year online NP program is equivalent to what it took them 10 years or more to learn? Your issue should not be with me, it should be with the Physicians, channel your energy into proving to them that your little online program is just as good as their medical training. I am not your enemy.

Specializes in Internal Medicine.

So because physicians don't have online schools, that means we shouldn't? Physicians go to school for 4 years, and then do a 3 year residency, maybe we should do that too. Maybe if physicians jumped off a bridge....we should too.

Again, where is the evidence based research that says an NP attending school online is clinically inferior to an NP that went to a brick and mortar?

Regardless of online or in person, physicians are threatened by our perceived lack of education. NP schools have existed for much longer than the internet has, and the physician lobby belief that NP's are inferior predates the advent of online schools. If we were magically to get rid of all the online schools tomorrow, do you really believe MD's would magically welcome us in with open arms and respect us as equals? Would we miraculously be given full autonomy in all states because those dastardly online schools are gone forever? Absolutely not. The fact would still remain that we receive less education than them, and that is enough for them to discriminate.

Many already ignore the fact that our clinical outcomes and patient satisfaction levels are on equal grounds and in some instances better. NP data outcomes are blind to where you went to school. NP's are not physicians, and we have already proven our education methods are still incredibly effective.

Lastly, I personally have nothing to prove. I work with a physician that has great respect for my profession, pays me well, and thinks MD's/DO's spend way too much time in school. I only take issue with nurses that think one education method is inferior because they're afraid of our perception to physicians.

Specializes in Pain Management, FNP, Med/Surg, Tele.

Baby needs a nap? Do you feel validated now? You got it all off your chest? Like I said, and I'll say it again, people make their own choice on what program they would like to attend, it's not up to me to decide which is better but I will maintain my opinion however you want to interpret it. My brick and mortar education gave me more training and I also have more experience than you.

Specializes in Internal Medicine.
Baby needs a nap? Do you feel validated now? You got it all off your chest? Like I said, and I'll say it again, people make their own choice on what program they would like to attend, it's not up to me to decide which is better but I will maintain my opinion however you want to interpret it. My brick and mortar education gave me more training and I also have more experience than you.

So I guess resorting to name calling is what DNP's do when they can't produce a shred of evidence? Just because you perceive yourself to have more training and experience doesn't make it so. If anything, the quality of your posts makes you sound ill-informed and uneducated. Seriously, name calling?

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